ABSTRACT
ObjectiveTo observe the effects of Xibining （XBN） and adipose stem cell exosome （ADSC-Exos） in the cases of separate or joint application on cartilage degeneration and mitochondrial autophagy and explore its mechanism of action to improve knee osteoarthritis （KOA）. MethodSD rats were divided into a sham operation group （sham group）， a model group， an ADSC-Exos group （Exos group）， an XBN group， and an ADSC-Exos+XBN group （Exos+XBN group）. KOA model was established by using anterior cruciate ligament transection （ACLT）. The pain sensitivity status of rats was evaluated， and the degeneration degree of the knee joint and cartilage tissue was detected by Micro-CT and pathological staining. The expression of p62 and LC3B was observed by immunofluorescence， and the serum levels of TNF-α， IL-1β， IL-6， and IL-15 in rats were detected by ELISA. The Western blot was used to detect the protein expression levels of MMP-3， MMP-13， ADAMTS5， ColⅡ， TIMP， ACAN， PINK1， Parkin， p62， and LC3A/B. ResultCompared with the sham group， rats in the model group showed decreased cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds， varying degrees of abrasion and loss of cartilage tissue， degeneration of cartilage tissue， elevated serum IL-1β， IL-6， IL-15， and TNF-α levels （P<0.01）， and increased protein expression of MMP-3， MMP-13， and ADAMTS5 in cartilage tissue. In addition， the protein expression of ColⅡ， TIMP1， and ACAN was decreased （P<0.01）. Compared with the model group， rats in each treatment group showed higher cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds， reduced cartilage tissue degeneration， lower serum levels of IL-1β， IL-6， IL-15， and TNF-α （P<0.05，P<0.01）， decreased protein expression of MMP-3， MMP-13， and ADAMTS5， and higher protein expression of Cold， TIMP1， and ACAN in cartilage tissue （P<0.05，P<0.01）. Moreover， the changes were the most obvious in the Exos+XBN group. ConclusionBoth ADSCs-Exos and XBN can increase the level of mitochondrial autophagy in chondrocytes and delay cartilage tissue degeneration by promoting the expression of the PINK1/Parkin signaling pathway， and the combination of the two can enhance the therapeutic effect.
ABSTRACT
Objective The purpose of the study was to identify the most frequently used nursing diagnoses,interventions,outcomes and linkages using standardized nursing terminologies for elderly patients with abdominal external hernia surgery.Methods For this study a descriptive design was used.The frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages were identified through 38 elderly patients with abdominal external hernia surgery who were admitted in hospital from March to August in 2014.Data were analyzed by SPSS17.0.Results The finding showed the most frequently used 5 nursing diagnoses were activity intolerance,impaired tissue integrity,deficient knowledge,chronic pain,and risk for falls,the frequency were 15.51％(38/245),15.51％(38/245),15.10％(37/245),14.69％(36/245) and 14.69％(36/245),the most frequently used 5 nursing outcomes were activity tolerance,ambulation,tissue integrity (skin and mucous membranes),wound healing (primary intention) and knowledge (diet) the frequency were 10.05％(38/378),10.05％(38/378),10.05％(38/378),10.05％(38/378) and 9.79％(38/378); the most frequently used 5 nursing interventions were environmental management (comfort),positioning,exercise therapy (ambulation,) incision site care and environmental management the frequency was all 6.96％(38/546).The most frequently used top 10 NNN linkages were also identified in this study.Conclusions The most frequently used NANDA-Ⅰ,NIC,NOC,and NNN linkages for patients with abdominal external hernia surgery from this study not only offer new knowledge to nurses but also provide scope of evidence-based nursing research in abdominal external hernia clinics.