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Objective: To explore the risk factors and preventive countermeasures of perioperative cerebral infarction. Methods and results: We reviewed the clinical medical records and anesthesia process of a perioperative stroke patient and reviewed the literature. Discussion: Perioperative stroke is the result of a combination of multiple factors. Medical complications such as long history of hypertension, diabetes, history of stroke and extreme low head during laparoscopy are risk factors for stroke. Conclusion: Laparoscopic surgery should monitor high risk factors, maintain intraoperative hemodynamic stability, hidden symptoms of posterior circulation cerebral infarction, and pay early identification and timely intervention to improve the prognosis of patients.
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Objective:To study the antibacterial properties and in vivo and vitro biocompatibility of Cu-Fe-Zn alloy microfilament dressings, and to evaluate their wound healing promoting effect through clinical application.Methods:We evaluated the comprehensive antibacterial performance of dressings in vitro using plate counting method; After co culturing the extract of Cu-Fe-Zn alloy microfilament dressings with epidermal cells (HaCaT) and fibroblasts (NIH-3T3), their in-vitro biocompatibility was determined through the cell counting kit-8 (CCK-8) test; Further, Cu-Fe-Zn alloy microfilament dressing was applied to the wound surface of diabetes mice to test the biocompatibility of the material in vivo; Through a prospective randomized controlled trial, 50 burn and trauma patients admitted to the Burn and Plastic Surgery Department of the Third Xiangya Hospital of Central South University were selected and divided into an observation group of 25 patients and a control group of 25 patients. The observation group was treated with Cu-Fe-Zn alloy microfilament dressing, and the control group was treated with silver nanoparticle antibacterial dressing. The wound healing time and wound treatment effect of the two groups were compared.Results:The Cu 2+ release concentration of Cu-Fe-Zn alloy microfilament dressings detected by inductively coupled plasma-mass spectrometry (ICP-MS) was 1.3 μ g/ml, which had the effect of promoting the proliferation of HaCaT and NIH-3T3 cells (all P<0.05). The antibacterial rate of Cu-Fe-Zn alloy microfilament dressing against pseudomonas aeruginosa, escherichia coli and staphylococcus aureus reached 100%. The wound healing rate [(87.39±1.83)%] of diabetes mice treated with Cu-Fe-Zn alloy microfilament dressing was significantly higher than that of the control group [(58.66±3.54)%, P<0.05]. The inflammatory response of the wound tissue was relatively mild and the wound margin matrix was intact. The wound healing time of 25 patients treated with Cu-Fe-Zn alloy microfilament dressing [(23.52±10.02)d] was shorter than that of the control group [(40.84±21.22)d] ( t=17.159, P<0.001), and the overall treatment response rate of patients (96%) was significantly higher than that of the control group patients (64%) (χ 2=8.472, P=0.015). Conclusions:Cu-Fe-Zn alloy microfilament dressings have good antibacterial properties and biocompatibility, and have significant therapeutic effects on promoting wound healing. They not only effectively promote wound healing but also exert anti infection effects, and are expected to be a new type of wound repair dressing.
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Wound repair is a fundamental task that the whole field of the Burn and Plastic surgery pays urgent attention to and longs for a breakthrough. In this column, wound repair balance laws theory is expounded and we are expecting people in the field gradually began to value the use of balance law. Guided by the law of balance principle, people are required to conduct scientific research, improve clinical technique and develop new materials. The theory is designed to improve the level of scientific research and clinical diagnosis, and will set up a new milestone in the field of wound repair.
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Objective To evaluate the effects of CHOICE management mode on adherence of adolescents with type 1 diabetes mellitus (T1DM). Methods A total of 49 adolescents with T1DM were elected using convenience sampling method, and divided into the experimental group (26 cases) and the control group (23 cases) by random number table. The experimental group received the CHOICE management for 1 year, while the control group received traditional education management. The patients′self-management behaviors and HbA1c were evaluated before the intervention and 1, 3, 6 and 12 months after the intervention. Results The scores of Control Problems, Attitude Toward Diabetes and Understanding Management Knowledge after 12-months intervention were (2.71 ± 0.43), (3.89 ± 0.60), (3.05 ± 0.71)points in the experimental group, (2.49 ± 0.33),(4.20 ± 0.40),(3.51 ± 0.70)points in the control group, there were significant differences (t=-2.101, 2.129, 2.289, P<0.05). The scores of Diet Adherence after 1 month and 3 months intervention were (2.85 ± 0.0.67), (2.79 ± 0.66)points in the experimental group, (2.39 ± 0.70), (2.38 ± 0.67)points in the control group, there were significant differences (t=2.170, 2.338, P<0.05). HbA1c was(8.29 ± 0.76)％ in the experimental group, (8.85 ± 1.14)％ in the control group, there was significant difference (t=-2.041, P<0.05). There were no significant differences at the others times between two groups (t=- 1.556-- 0.527, P>0.05). Conclusions CHOICE management mode can effectively improve the self-management behavior of adolescents with T1DM.
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Objective To explore the correlation between NF-κB signaling pathways activated by IL-18 in CD4+ T cells and the pathogenesis of PBC.Methods We detected the expression of IL-18 mRNA in PBMCs,IL-18 level in plasma,receptor IL-18R on surface of CD4+ T cell,proliferation rate of CD4+T cell and its NF-κB signaling pathway protein IκBα and NF-κB p65 by qRT-PCR,ELISA,flow cytometry,MACS and Western blot on 32 cases of patients with PBC (PBC group) and 32 healthy people (control group) in Guizhou provincial people′s hospital.Results The level of IL-18 in PBC group was significantly higher than that in control group (P<0.05).The relative expression of IL-18 mRNA in PBC group was significantly higher than that in control group (P<0.05).The percentage of CD4+T cells expressing IL-18Rα in PBC group was higher than that in control group (P<0.05).The proliferation rate of CD4+T cells stimulated by IL-18 in PBC group was significantly higher than that in healthy control group (P<0.01).The relative expression levels of NF-κB p65 protein were up-regulated in IL-18,and the expression of IκBα protein in each group was significantly increased,especially in PBC group (P<0.01).Conclusion IL-18 can activate NF-κB signal pathway in CD4+ T cells and participate in the pathogenesis of primary biliary cirrhosis.
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Objective To investigate the cognition of the monitoring and management of blood glucose critical values among clinical nurses. Method Totally 112 clinical nurses from 28 departments of the hospital were involved in the investigation with a self-designed questionnaire. Results The average score on monitoring and management of blood glucose critical values was (79.69 ± 14.12). 53 nurses (47.32%) were at a medium or lower level. There were significant differences in the scores among the nurses of different age, work experience, education level and professional title (P<0.05). Conclusions The clinical nurses have inadequate knowledge about the monitoring and management of blood glucose critical values. The hospital administration should carry out various training methods for nurses to improve their ability in nursing diabetic patients.
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Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22％).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age ＞65 year (OR =1.123,95％ CI:1.013-1.244,P =0.027),lesion size ＞ 3.5 cm (OR =1.173,95％ CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 ％ CI:1.460-8.379,P =0.005),hospital stay ＞ 10 d (OR =2.480,95％ CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95％ CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.
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Objective To explore the effect of the team of diabetes care specialists on the management of blood glucose for clinical nurses. Methods The hospital formed a team of diabetes care specialists , they designed a questionnaire of the diabetes care then surveyed the clinical nurses. According to the survey, the team organized the training program for 2 months and compared the result of the training. Result The differences of these five dimensions between before and after training were statistically significant (P﹤0.05). Conclusion The training can greatly improve the monitoring and management of blood glucose critical values and the technical of diabetes nursing.
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Objectives To study the relationship between hope and quality of life(QOL)in nasopharyngeal carcinoma(NPC) patients undergoing radiotherapy(RT). Methods One hundred and ten NPC patients undergoing radiotherapy participated in the investigation by the Herth Hope Index(HHI)and the Functional Assessment of Cancer Therapy-head and neck scale(FACT-H&N),to look into the correlations between their hope and QOL.Result The scores on hope and NPC for the QOL patients during radiotherapy were(34.80±2.64)and(91.34±13.19),respectively and they were positively correlated(r=0.253,P<0.01). Conclusions The hope of the NPC patients is at the medium level.Their hope is positively correlated with QOL.The higher level the hope is,the higher the QOL.
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ObjectiveTo investigate the histological features, clinical presentation, treatment and prognosis of small cell carcinoma of the prostate.MethodsThe clinical, pathological and follow-up data of two cases of small cell carcinoma of the prostate were respectively analyzed, and the related literature was reviewed.ResultsTwo cases of small cell carcinoma were diagnosed by transtectal prostate biopsy. Microscopically, the tumor arranged in nest structures and exhibited small round cells with the nuclei extremely hyperchromatic and scanty. Coagulated necrosis was easily observed. The immunohistochemical testing was positive for NSE and negative for PSA 、PAP. Case 1 received palliative surgery and postoperative chemotherapy of EP (VP-16, Cisplatin), and died of recurrence and distant metastasis after six months. Case 2 received palliative surgery and oral bicalutamide treatment, and died of recurrence and liver metastasis after three months.ConclusionsSmall cell carcinoma of the prostate has the biological behavior of invasive growth with an unfavorable prognosis, which is often in an advanced stage at first diagnosis. The ultimate diagnosis depends on histopathology and surgery combined with systemic chemotherapy and radiotherapy is the most effective treatment.
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Eukaryotic translation initiation factor eIF2B, the guanine nucleotide exchange factor (GEF) for eIF2, catalyzes conversion of eIF2·GDP to eIF2·GTP. The eIF2B is composed of five subunits, α, β, γ, δ and ɛ, within which the ɛ subunit is responsible for catalyzing the guanine exchange reaction. Here we present the crystal structure of the C-terminal domain of human eIF2Bɛ (eIF2Bɛ-CTD) at 2.0-Å resolution. The structure resembles a HEAT motif and three charge-rich areas on its surface can be identified. When compared to yeast eIF2Bɛ-CTD, one area involves highly conserved AA boxes while the other two are only partially conserved. In addition, the previously reported mutations in human eIF2Bɛ-CTD, which are related to the loss of the GEF activity and human VWM disease, have been discussed. Based on the structure, most of such mutations tend to destabilize the HEAT motif.
