Objective To study the related factors in diabetic patients with lOwer extremital deep vein thrombosis(DVT) and the nursing strategy. Methods 58 diabetic cases underwent lower limbs 99mTc-MAA veins imaging and/or ultrasunography. The related laboratory data such as fasting plasma glucose(FPG),blood cholesterol, blood triglycerides and clinic informations such as age, disease courses, lower limbs symptoms (swelling, erooted veins and diabetic foot) and acute complication (diabetic ketoacidosis and hyperosmolar non ketotic diabetic coma) were collected simultaneously. The relationship of each factors with DVT incidence were analyzed. Results 28 patients (48.3%) complicated with lower limbs DVT. The DVT incidence was signifi-cantly different among patients with different age, disease courses, FPG, blood cholesterol, blood triglycerides, lower limbs symptoms and acute complication, respectively. No significant difference was seen in patients with different blood pressure, body weight index, diabetes type. Conclusions Various dangerous factors accumu-lating in DM such as old age, long disease courses, high FPG, high blood cholesterol and high blood triglyc-erides contribute to the high incidence of lower limbs DVT. Early intervention, comprehensive treatment and in-tensive nursing should be applied to reduce the incidence of DVT.

Objective To study the related risk factors of pulmonary embolism(PE) in diabetic patients.Methods 58 diabetic cases were underwent lower limbs 99mTc-MAA veins imaging(and/or ultrasonography) and pulmonary perfusion imaging.The related laboratory data [fasting blood glucose(FBG),blood cholesterol,blood long chain triglycerides(LCT)]and clinial informations [age,disease courses,chest symptoms(chest pain and short of breathe),lower limbs symptoms(swelling,crooted veins and diabetic foot) and acute complication(diabetic ketoacidosis and hyperosmolar non ketotic diabetic coma)]were collected simultaneously.SPSS was used for χ2-test and Logistic regression analysis.Results 28 patients(48.3%) were showed to be with lower limbs deep vein thrombosis (DVT) and by 99Tcm-MAA imaging,10 cases(17.2%) with PE.The PE ratio(32.1%) of the patients with DVT was more higher than no DVT(3.3%)(χ2 = 6.53,P＜0.05).Single factor analysis showed the PE ratios had significant difference to factors of chest symptoms,lower limbs symptoms and acute complication(all P＜0.05),respectively.There were no significant difference in other factors of age,disease courses,FBG,blood cholesterol,LCT,blood pressure,weight index,DM type(all P＞0.05),respectively.Multiplicity analysis indicated:the related risk factors of PE included chest symptoms(Score = 13.316,P＜0.01) and lower limbs symptoms(Score = 7.780,P＜0.01).There were no significant differences in other factors(all P＞0.05),respectively.Conclusion The serious DM with chest symptoms,lower limbs symptoms and/or DVT could be controlled as early as possible by all kinds of treatment.It would decrease the PE complication.

Objective To investigate the application of colostomy care products in managing the leakage around PTCD drainage tube, and to discuss its clinical effect. Methods A total of 56 patients with malignant obstructive jaundice, who had received PTCD and suffered from postoperative leakage around PTCD drainage tube, were randomly and equally divided into the study group (n=28) and the control group (n=28). The colostomy care powder, the skin protective film and the colostomy bag were used for the patients of the study group, while iodophors, sterile gauze and mupirocin ointment were employed for the patients of the control group. The incidence of irritant dermatitis around PTCD drainage tube, the degree of comfort to the indwelling tube judged by the patient, and the nursing workload for PTCD drainage tube were determined, and the results were compared between the two groups. Results The incidence of irritant dermatitis around PTCD drainage tube in the study group was obviously lower than that in the control group. And the degree of comfort to the indwelling tube judged by the patient in the study group was much higher than that in the control group. The differences between the two groups were statistically significant (P<0.05). Conclusion Combination use of colostomy care powder, skin protective film and colostomy bag can effectively reduce the incidence of irritant dermatitis around PTCD drainage tube and improve the patient’s condition. Therefore, this method is worthy of popularization in clinical practice.

OBJECTIVETo investigate the occurrence of epithelial to mesenchymal phenotype transition (EMT) in the liver of rats following bile duct ligation (BDL).

METHODSTwenty-four male Wistar rats were randomized into sham-operated group and BDL group. Liver fibrosis of the rats was evaluated by HE staining and Masson's trichrome staining. Western blotting was used to detect the expression levels of the epithelial markers albumin and E-cadherin and the mesenchymal markers type I collagen and vimentin in the liver tissue. Immunofluorescence was employed to determine the co-localizations of FSP-1+vimentin, FSP-1+type I collagen, FSP-1+albumin, and albumin+type I collagen in cells.

RESULTSCompared with those in sham-operated group, the rats in BDL group showed significantly increased ISHAK fibrosis score (4.42+1.16 vs 0, P+0.000), METAVIR fibrosis score (3.42+0.67 vs 0, P+0.000) and type I collagen levels (0.30+0.06 vs 0.11+0.07, P+0.000) with up-regulated protein levels of albumin (0.53+0.63 vs 1.12+0.01, P+0.000) and E-cadherin (0.21+0.01 vs 0.44+0.01, P+0.000) and down-regulated type I collagen (8.21+0.12 vs 0.24+0.01, P+0.000) and vimentin (3.14+0.01 vs 0.37+0.01, P+0.000). The number of cells with co-localizations of FSP-1+vimentin, FSP-1+type I collagen, FSP-1+albumin, and albumin+type I collagen was also significantly increased in BDL group.

CONCLUSIONBDL causes significantly decreased expression of epithelial markers and increased expressions of the mesenchymal markers in rats, indicating the occurrence of EMT in some of the liver cells.

Animals ; Bile Ducts ; surgery ; Cadherins ; metabolism ; Collagen Type I ; metabolism ; Epithelial-Mesenchymal Transition ; physiology ; Ligation ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; etiology ; metabolism ; pathology ; Male ; Phenotype ; Rats ; Rats, Wistar ; Vimentin ; metabolism

Objective: To assess the clinical characteristics and identify the risk factors in the acute myocardial infarction (AMI) patients complicating with ventricular septal rupture (VSR). Methods: A retrospective study was performed on 96 AMI patients complicating with VSR, who were hospitalized in the Second Xiangya Hospital of Central South University, Hunan Provincial Peoples′ Hospital, the First Affiliated Hospital of University of South China, the Second Affiliated hospital of University of south China, Xiangtan Central Hospital from December 2007 to May 2017. There were 46 females and the age was (66.2±10.7) years (from 43 to 90 years). Patients were divided into in-hospital survival group (n=64) and in-hospital death group (n=32). The 96 patients were also divided into the early death group (survived ≤2 weeks after admission, n=50) and non-early death group (survived>2 weeks after admission, n=46). Multivariate logistic regression was used to analyze the independent risk factors of the early death. Results: Location of VSR was available in 71 patients, VSR was located at the apical or anterior septum near the apical region in 64.0% (32/50) patients with the anterior AMI, VSR was located at the posterior wall and basal inferior segment in 57.1% (12/21) patients with non-anterior AMI. Compared to the in-hospital survival group, patients in the in-hospital death group were older ((69.6±11.3) years vs. (64.6±10.1) years, P=0.031), incidence of non-ventricular aneurysm (71.9% (23/32) vs. 37.5% (24/64), P=0.001) and anterior AMI (84.4%(27/32) vs. 62.5%(40/64), P=0.028) was significantly higher in the in-hospital death group than in the in-hospital survival group. The comparison between the early death group and non-early death group showed that older age, female, no history of angina or myocardial infarction, Killip grade>Ⅲ, and non-ventricular aneurysm were related to increased risk of the early mortality in this patient cohort. Logistic regression analysis revealed that female (OR=5.109,95%CI 1.19-22.00, P=0.012), no history of angina or myocardial infarction (OR=23.34, 95%CI 3.44-158.37, P=0.001), Killip grade>Ⅲ(OR=5.35, 95%CI 1.26-22.66, P=0.019) and non-ventricular aneurysm (OR=6.30,95%CI 1.67-23.73, P=0.005) were independent risk factors for early death in this patient cohort. Conclusion The risk factors of in-hospital death include older age, non-ventricular aneurysm and anterior AMI. Female, no history of angina or myocardial infarction, Killip grade>Ⅲ and non-ventricular aneurysm are independent risk factors for the early death of AMI patients complicating VSR.

Objective To investigate the potential of polylactic acid glycolic acid copolymer (PLGA) composite ordered multi tunnel collagen scaffold in fabricating a biomimetic artificial nerve graft to repair the sciatic nerve defects in rats.Methods The ordered multi tunnel collagen scaffold was prepared by vacuum freeze-drying and directional drawing method to simulate the epineurium;the outer conduit was prepared by PLGA to simulate the epineurium;and then,the ordered multi tunnel collagen scaffolds were loaded in the PLGA conduit (5∶1) under a stereomicroscope to develop a novel biomimetic artificial nerve.Sixty-four rats were randomly divided into four groups:artificial nerve group,PLGA group,peripheral nerve group,and non-graft control group (n=16);rats in the artificial nerve group,PLGA group,and peripheral nerve group were repaired with artificial nerve graft,hollow PLGA conduit and allogeneic sciatic nerve to bridge the sciatic nerve defect,while the sciatic nerve with the gap in rats of the control group was without any grafting.After 11 weeks of operation,the hind limbs of rats in each group were detected by behavioral test,electrophysiological examination and Fluoro-Gold retrograde tracing method.The changes of muscle tissues (gastrocnemius) were observed by hematoxylin staining and TMR-α-BTX staining,and the regenerated axons were observed by immunohistochemical staining with NF200 and the regenerative spinal anterior horn motor neurons were observed by Nissl fluorescence staining 12 weeks after operation.Results After 11 weeks of operation,the recoveries of the motor functions (the distance between the injured hindlimb and forelimb,the rotation angle of the injured foot) in the peripheral nerve group,artificial nerve group,PLGA group and control group were significantly deteriorated in turn,and the differences were statistically significant (P＜0.05).Electrophysiological examination showed that the recovery effect of peripheral nerve group was the best in both latency and amplitude of the compound muscle action potential,followed by artificial nerve group.The latency of PLGA group was the longest and the amplitude of compound action potential was the smallest;significant differences were noted between each two groups (P2＜0.05).At 12 weeks after operation,the wet weight ratio of muscle fibers,area of muscle fibers and neuromuscular junction area were significantly different between each two groups (P＜0.05);the degree of gastrocnemius atrophy in the artificial nerve group was significantly improved than that in the PLGA group,but not yet reached the level of peripheral nerve group.NF200 immunohistochemical staining showed that a large number of NF200-positive axons were seen in the grafts of the artificial nerve group,but the number was slightly smaller than that of the peripheral nerve group;the number of regenerated axons in the PLGA group was the smaller and mainly distributed near the proximal side.In the PLGA group,only (19.33 ±6.73)％ regenerated spinal anterior horn motor neurons were labeled with Fluoro-Gold,while the positive rates of Fluoro-Gold in the artificial nerve group and peripheral nerve group were (42.67±7.45)％ and (50.13±4.33)％;the differences between each two groups were statistically significant (P＜0.05).Conclusion The biomimetic artificial nerve made of PLGA conduit and ordered multi tunnel collagen scaffold can efficiently reconstruct the defected peripheral nerve with guiding axonal regeneration and promoting functional restoration in rats;however,its effect is poor than peripheral nerve grafting.