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Objective:To optimize the clinical nursing pathway, service program and evaluation parameters of percutaneous coronary intervention(PCI), for references for the cost accounting and compensation mechanism of nursing program in public hospitals.Methods:After literature analysis and group discussion, the initial templates were constructed for the PCI clinical nursing pathway, nursing service projects, and their evaluation parameters. 15 experts were consulted by two rounds of Delphi method to optimize PCI nursing path, nursing service items and their evaluation parameters (basic labor consumption, basic time consumption, technical difficulty and risk degree).Results:Two rounds of Delphi method finally determined the PCI clinical nursing path and 27 nursing service items, and adjusted the evaluation parameters of 10 nursing service items. The new projects for PCI clinical nursing services included adjustment and review of dual antiplatelet therapy plans, postoperative rehabilitation nursing, and key project verification. The three nursing service projects with the highest level of technical difficulty and risk were intravenous blood transfusion, gastric catheterization, and gastrointestinal decompression. The two items with the highest importance assigned were high pump assisted arterial/venous infusion (blood) and invasive continuous arterial blood pressure monitoring.Conclusions:The PCI clinical nursing pathway and nursing service project constructed in this study could closely integrate with clinical practice, highlight the integrated nursing service model, and reflect the labor value of nurses.
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Objective@#To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. @*Materials and Methods@#This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student’s t test, and Pearson’s correlation coefficient. @*Results@#T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). @*Conclusion@#CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.
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Objective@#To analyze knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle school students in Hangzhou and to provide a scientific basis for schools to carry out targeted prevention and control measures.@*Methods@#Anonymous network sampling survey was carried out through the questionnaire star, and a total of 14 216 subjects from primary and middle school in Hangzhou were recruited to fill in the questionnaire regarding knowledge, attitudes and practice of COVID-19 from March 3 to March 7, 2020.@*Results@#Primary and middle school students showed high awareness rate of transmission (85.83%) and incubation period (77.44%), but lower awareness on symptoms (44.70%) of COVID-19. The practice of wearing masks, cough etiquette and correct hand washing were 97.27%, 88.01% and 91.82%, respectively. The protective practice among primary and middle school students were generally good, 91.21% of them were at moderate level or above. 83.91% of primary and secondary school students reported worries about infection of COVID-19, and 55.42% of primary and secondary school students were anxious about returning to school. Primary school students and rural students were more anxious about returning to school(χ 2=46.66, 26.70, P<0.05).@*Conclusion@#The primary and middle school students in Hangzhou have a relatively good level of knowledge and practice concerning COVID-19. Yet, it is necessary to carry out targeted health education and strengthen mental health education for primary and middle school students.
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Objective To explore the value of DTI quantitative parameters in evaluating neurological function changes of acute traumatic spinal cord injury (TSCI)in rat models.Methods The modified Allen's dropping weight technique was used to establish TSCI rat models.Then the rats were divided into mild injury group,moderate injury group and severe injury group (each n=10).DTI examination and Basso-Beattie-Bresnahan (BBB) score were performed pre-TSCI and 0 h,6 h,24 h,3 day,7 day and 14 day post-TSCI,respectively.The BBB scores and DTI parameters,including FA,mean apparent diffusivity (MD),radial diffusivity (RD) and axial diffusivity (AD) were measured and compared among groups.The correlation between BBB scores and the parameters was evaluated.Results The differences of FA,MD and RD value were statistically significant among varying injury degree groups and different time points after TSCI (all P＜0.05).AD value had statistical difference among different time points (F=12.720,P＜0.001),whereas no difference was found among varying injury degree groups (F=0.469,P=0.630).FA and MD values decreased while RD increased 0 h post-TSCI.Then RD and MD increased continuously,whereas FA decreased continuously until 24 h post TSCI (all P＜0.05),and the parameters kept stable after 24 h post-TSCI (all P＞ 0.05).The BBB scores were lowest on 0 h post-TSCI,then maintained increasing (all P＜0.05).In addition,the BBB scores and MD values had good correlation (r=0.958,P＜ 0.01).Conclusion DTI can quantitatively evaluate function changes of TSCI in rat models.Moreover,treatment within 24 h post-TSCI might be recommended for TSCI therapy.
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Objective To analyze MRI features of intraspinal ganglioneuroma,in order to improve the ability of preoperative diagnosis.Methods MRI data of 9 patients of intraspinal ganglioneuroma confirmed pathologically were analyzed retrospectively.The location,morphology,size,signal intensity and degree of enhancement of these lesions were observed.Results Totally 9 lesions were enrolled.Four lesions occurred in the cervical spine,2 in the thoracic spine and 3 in the lumbosacral spine.Seven lesions were dumbbell shaped,involving both intra and extra-canalicular,and 2 lesions present as nodules in the foramen.All the lesions demonstrated homogeneous or heterogeneous high signal on T2WI,with only 1 lesion showed cystic change and necrosis.Contrast-enhanced scanning was performed in 8 lesions,and marked enhancement was shown in 3 lesions,mild-moderate enhancement in 5 lesions.Strand-shaped enhancement took place in 4 lesions.The intervertebral foramina of all the lesions were enlarged,but without bone destruction.Conclusion Intraspinal ganglioneuroma has some characteristics on MRI,which may be helpful to accurate preoperative diagnosis.
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To establish an animal model of acute-on-chronic liver failure (ACLF) that would replicate the pathological process of ACLF in humans, rats were administered porcine serum (PS) for 11 weeks. Liver fibrosis was determined by pathological and biochemical assessments. The animals then were injected with d-galactosamine (d-gal) and lipopolysaccharide (LPS). The survival times of animals with cirrhosis and ACLF were determined over 48 h. Other animals were killed at 0, 4, 8 and 12 h after administration of d-gal/LPS. Liver injury was assessed by histopathological analysis and biochemical indices, and apoptosis was detected by Western blot and TUNEL analysis. After PS administration for 11 weeks the serum levels of hyaluronic acid and N-procollagen type III peptide increased significantly, and serious fibrosis and cirrhosis was observed at weeks 10 and 11. Cirrhotic rats were injected with d-gal/LPS to induced ACLF; the rate of mortality over 48 h was 80%. ALT and AST levels increased markedly at 4 h, but decreased significantly at 8 and 12 h post-treatment. The total bilirubin, direct bilirubin, and total bile acids levels increased markedly at 8 and 12 h. Clotting times, TNF-and IL-6 levels increased significantly, except for 12 h post-treatment. Apoptosis, inflammation and necrosis were elevated as determined by hematoxylin-eosin staining and TUNEL assays. BCL-2 levels decreased significantly, While BAX levels increased significantly. Cytochromeexpression peaked at 8 h post-d-gal/LPS treatment. In conclusion, an ACLF model induced by PS and d-gal/LPS was established and the underlying mechanisms of ACLF development were explored.
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Objective To verify whether early growth response-3(EGR3) gene is targeted by microRNA-181b using molecular biology methods so as to provide guidance for the subsequent study on microRNA-181b`s role in the molecular mechanisms of schizophrenia.Methods Bioinformatic methods predicted that EGR3 gene is targeted by microRNA-181b.PCR methods amplified the fragment in EGR3 gene 3`UTR including the putative microRNA-181b binding site.Then the sequence was cloned into the pmirGLO luciferase vector.The DNA sequences of the amplified fragments were identified by restriction enzyme digestion and sequencing, and were consistent with the reference sequence from UCSC.This constructed vector was marked as pmirGLO-EGR3 vector.Finally, the pmirGLO vector, the pmirGLO-EGR3 vector, microRNA-181b mimics and negative control (NC) were divided into 5 groups and transfected into HEK393T cells;the luciferase activity was tested by dual luciferase reporter gene assay.Results The results of restriction enzyme digestion and sequencing demonstrated that the PCR fragmentwas successfully cloned into pmirGLO vector.The transfection results showed that the recombinant plasmid was successful transfected into HEK293T under the fluorescence microscope, with transfection efficiency being about 90％.The results of dual luciferase activity assay demonstrated that microRNA-181b significantly decreased the reporter gene`s activity compared with the NC.Conclusion At the cellular level, the schizophrenia susceptibility gene EGR3 was verified to be targeted by micorRNA-181b, which provides a new clue for the subsequent study on microRNA-181b`s role in the molecular mechanisms of schizophrenia.
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Malignant pleural mesothelioma (MPM) is a tumor of mesodermal origin that arises from the serosa of the pleura, peritoneum, pericardium or tunica vaginalis. MPM is well known to have a poor prognosis with a median survival time of 12 months. Accurate diagnosis, staging and restaging of MPM are crucial with [18F] flurodeoxy-D-glucose positron emission tomography (FDG PET/CT) playing an increasingly important role. Here we report a case of MPM with unusual contiguous soft tissue spread of the tumor along the dermal and fascial planes characterized by PET/CT. Given that the loco-regional tumor in the thorax was under control on PET/CT, the death of the patient was most likely associated with physiologic or metabolic causes associated with an extra-thoracic tumor.
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Humans , Chemotherapy, Adjuvant , Diagnosis , Mesoderm , Mesothelioma , Neoplasm Metastasis , Pericardium , Peritoneum , Pleura , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Prognosis , Serous Membrane , ThoraxABSTRACT
Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease usually managed by serial surgical repairs. The repaired prosthetic valve or conduit is susceptible to life-threatening infection. FDG-PET is an effective alternative to evaluate the source of infection when other examinations are inconclusive. We report an unusual case of an infected pulmonary artery conduit after TOF repair although the echocardiogram was negative for vegetation, which was later confirmed by surgery and pathology. The case highlights the role of FDG-PETas a problem-solving tool for potential endocarditis and cardiac device infection cases after complex cardiac surgery.
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Endocarditis , Heart Defects, Congenital , Pathology , Pulmonary Artery , Tetralogy of Fallot , Thoracic SurgeryABSTRACT
OBJECTIVE@#To investigate the expressions of transforming growth factor beta1 (TGF-beta1) and bone morphogenetic protein-2 (BMP-2) in human mandible fracture callus and their quantity changes in the process of healing.@*METHOD@#Thirty callus samples from the fractured mandible bone stumps were collected during operation, and two callus samples were collected from the angle-square jaw patients as controls. The expressions of TGF-beta1 and BMP-2 were test by the immunohistochemistry technic-SABC-staining in different periods of human fractured mandibular callus and in osseous tissue of normal angle of mandible.@*RESULT@#The TGF-beta1 and BMP-2 were expressed in callus of different periods but not in normal bone tissue. The expression of TGF-beta1 increased slowly during the first three weeks after fracture and reached its maximum in the third week, and then weakened gradually. The expression of BMP-2 increased gradually during the first two weeks after fracture and reached its maximum in the second week, then the expression weakened gradually.@*CONCLUSION@#(1) BMP-2 may be one of the factors promoting the repair of fracture. (2) TGF-beta1 could be another signal pathway in repairment of fracture. (3) There could exist some synergistic effects between TGF-beta1 and BMP-2 in the process of fracture healing.
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Adult , Humans , Middle Aged , Bone Morphogenetic Protein 2 , Metabolism , Fracture Healing , Mandibular Fractures , Metabolism , Transforming Growth Factor beta1 , MetabolismABSTRACT
Objective To investigate the risk factors of uroschesis in patients with cervical cancer after extensive hysterectomy.Methods The clinical data of 92 patients with cervical cancer who had undergone extensive hysterectomy plus pelvic lymph node dissection from August 2008 to June 2011 were analyzed retrospectively.The incidence rate and related risk factors of uroschesis after operation were analyzed.Results Thirty-one of 92 cases had postoperative uroschesis.The incidence rate of uroschesis was 33.70％.Univariate analysis showed that age,intraoperative blood loss,time of indwelling urinary catheter and urinary tract infection had significant correlation with postoperative uroschesis (P ＜0.05).While operative time,clinical stage,pathological type,preoperative adjuvant therapy,postoperative wound infection or fat liquefaction had no obvious correlation with postoperative uroschesis (P＞ 0.05).Multivariate Logistic regression analysis showed that age,time of indwelling urinary catheter and urinary tract infection were risk factors of postoperative uroschesis.Conclusions Age,time of indwelling urinary catheter and urinary tract infection are independent factors of postoperative uroschesis.The key method to reduce the incidence rate of postoperative uroschesis is to shorten the continuous catheterization time with comprehensive measure,to prevent and control urinary tract infection in early time.
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The purpose of the present study is to use beta-cyclodextrin polymers (beta-CDP) with different cross-linked degree (CLD) to form inclusion complexes with ibuprofen and examine the effects of structural and compositional factors of beta-CDP on its drug loading and release behaviors. A series of beta-CDP with different CLD were synthesized and characterized by Fourier Transform Infrared Spectroscopy (FT-IR) and 13C NMR spectrum. The beta-CDP was systemically characterized for the relation between the CLD of beta-CDP and the drug loading and release as well. The results of FT-IR and 13C NMR showed that similar peak-shaped vibration of beta-CDP and beta-CD implies that the polymer keeps the original characteristic structure of beta-CD. The CLD of the beta-CDP played a critical role in the drug loading and release, increasing the CLD resulted in reduction of drug loading, but increase in drug release.
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Bcl-2 gene is the human homologous gene of anti-apoptotic gene Ced-9 in c-elegans, which can participate in regulations of cells apoptosis including suppression of neuronal apoptosis in cerebral ischemic penumbra.This review is about Bcl-2 anti-ischemic neuron injury, its possible mechanisms and the effects of anti-ischemic drugs on Bcl-2.
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Background and purpose:In order to look for the new biomarker with higher specificity and sensitivity, we investigated the relationship between expression of MGB-2 and chemotherapy response, and tried to find out whether MGB-2 may sever as a prognostic factor for the patients with ovarian carcinoma. Methods:The expression of MGB-2 was detected by flow-cytometry technology in ovarian carcinoma tissue. We analyzed the correlations among MGB-2 expression and clinical pathological factors, therapeutic effect and prognosis of the patients with ovarian carcinoma.Results:Positive detection of MGB-2 was 78%.(66/885). For the patients whose serum CA125 level did not drop to normal level after two courses of chemotherapy, the MGB-2 positive rate was significantly higher than in those whose serum CA125 level decreased markedly ( 85% vs. 62%, P=0.018). The positive rate was also higher in patients with recurrent disease than in those without recurrence (83% vs. 67%, P=0.097). In univariate survival analysis, the expression of MGB-2 was significantly associated with median survival time (P=0.021).Conclusions:MGB-2 expression is correlated with chemotherapy response and poor prognostic for the patients with ovarian carcinoma.
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Background and purpose:urokinase-typeplasminoogen activator receptor(uPAR) plays important roles in terms of fibrolysis in tissue,cell adhering prolifration and signal transduction uPAR can the detected in both cancer and matrix cells.It has been reorted that uPAR is associated with invasion and metastasis of cancer cells.This paper is to study the effects of the gene expression of uPAR and VEGF-C on onco-genesis and progression of ovarian cancer.Methods:The expression of uPAR gene protein and VEGF-C were examined immunohistochemically in 58 cases of ovarian serous cystadenocarcinoma,10 cases of borderline serous cystadenomas and 13 cases of serous cystadenocarcinoma.The relationships between the results and pathological features were studied.Results:① The expressions of uPAR in benign and malignant tumors were different significantly(P
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AIM:To study the protective effect and mechanism of Gujingdan(Radix Astragali,Fructus Alpiniae oxyphyllae,Radix et Rhizoma Salviae miltiorrhizae,Herba Epimedii,Semen Euryales,etc.) on the acute renal injury caused by Gentamicin in rats.METHODS:90 rats were randomly divided into normal control group,pathologic model group,preventive group which included high,middle and low dosages of Gujingdan(4 g/kg,2 g/kg,1 g/kg) and positive control group which was treated with Shenkangning(2 g/kg) and treated group which included the same groups as the preventive group.The preventive groups were respectively given Gujingdan and Shenkangning for two weeks and ahead one week.On the seventh day,except the normal group the others were continuously injected gentamicin by abdominal cavity(100 mg/kg/day) seven days.At the same time,the treated group were given Gujingdan and Shenkangning by ig for seven days.When the experiment was over,the content of ?-N-acetyglocosamidase(NAG),serum creatinine(SCR) and blood urea nitrogen(BUN) were examined,and the renal histological changes were observed.RESULTS:NAG,BUN,SCR of the groups which were treated with Gujingdan were remarkly lower than that of the pathologic model group;SOD、ATP were higher and MDA was lower than that of the model group.Histological changes showed that renal tubular epithelial cells of the groups treated with Gujingdan were similar to the changes of normal group and much better than that of positive group and pathologic model group.CONCLUSION:Gujingdan has the protective effect on acute renal injury caused by Gentamicin.The mechanism may be that Gujingdan has the function of inhibiting oxidation,protecting and stabilizing cell membrane.
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Neurotrophic factors are proteins that play an important role in the development and maintenance of neural networks. They released in the brain's response to injury and in neurodegenerative disorders and took part in the protective process. The fact that they can be used to prevent damage to neurons associated with brain lesions in animal models of neurodegenerative disorders supports the above mentioned hypothesis as well. However, they are proteins that do not easily cross the blood brain barrier. The induction of neurotrophic factors by systemically administered some medicines would be an elegant way to overcome problems of application.
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In both clinical and animal experiments,it has been confirmed that the inflammation in brain is involved in the development of brain damage after the ischemia.However,the pro-inflammatory mechanism is extremely complicated.Recently,a growing number of reports indicates that many factors play their roles in the inflammation,such as leukocyte,interleukin-1?(IL-1?),tumor necrosis factor(TNF)and mast cells.They are released/presented in the region of cerebral ischemia and include both ischemic and secondary brain injury.