Objective To explore the differences of cultivation and differentiation between cortical neural stem cells(C-NSCs) and mesencephalic neural stem cells(M-NSCs). Methods We dissociated embryonic cortex and ventral mesencephalon respectively,and single cell suspensions were achieved by trypsin digestion and mechanical dissociation in sterile condition.These cells were planted into DMEM/F12 culture medium with B27,bFCF,and then were passaged by mechanical methods and induced to differentiation in DMEM/F12 medium with 10%FBS(without growth factors).For examining the features of C-NSCs and M-NSCs,reverse phasecontrast microscopy,immunocytochemical techniques were applied to detect nestin,NSE,GFAP antigens and the specific antigen(TH) of neurons differentiated from the two kinds of NSCs.We observed and compared the difference of the two kinds of NSCs. Results The NSCs existed both in cortex and ventral mesencephalon of embryonic mice,which expressed nestin and possessed the ability of self-renewing and multipotent, but the density of NSCs in cortex was higher than that in ventral mesencephalon.There were some TH positive cells differentiated from M-NSCs but none came from C-NSCs.Conclusion The proliferative activity of C-NSCs is higher than that of M-NSCs,but more number M-NSCs differentiated into dopaminergic neurons in serum medium.

Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was (11.5±3.6) ml/s,and the mean maximal detrusor pressure was (39.1±17.8) cmH2O.Combining with the voiding radiography,19 patients were diagnosed as bladder neck obstruction,and the other 2 were diagnosed as urethral stricture.All patients were accepted the hydrodistension under the epidural anesthesia.The bladder biopsy was performed if the typical glomerulations were observed under the cystoscopy.Bladder neck incision and urethral dilatation were performed on these patients respectively.Symptom changes of bladder pain were recorded by using O'Leary-Sant scale,the pain,urgency,frequency symptom (PUF) scale and quality of Life (QOL) Scale.The data were collected within 48 months postoperation,respectively.Results The pathological findings of bladder mucosa biopsy showed acute or chronic inflammation in all patients.The mean follow-up was 6.7±5.9 months.We compared the corresponding data such as:voiding times per day,nocturnal frequency,O'Leary Sant scores,PUF and QOL between pre and post-treatment.Significant differences were observed during all corresponding data (P＜0.05).The voiding times per day changed from 24.3± 11.8 to 13.0±5.9.The nocturnal frequency decreased from 6.5±2.7 to 3.3± 1.6.O'Leary Sant scores changed from 24.6±7.3 to 14.7±7.4.The PUF scores changed from 22.9±6.2 to 12.0± 7.1.And the QOL scores changed from 5.0±0.8 to 2.9±1.5.Conclusions Free urinary flow rate and residual urine combined with VUD are very important in diagnosing female BOO with bladder pain as major symptom.Bladder pain symptoms will be significantly improved after the obstruction was relieved according to VUD results.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Objective: To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis. Methods: From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension. Results: There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months. Conclusions The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.

【Objective】 To analyze the factors affecting "one-time yield" in blood plasma separation (BPS) and explore the methods to improve the rate of it. 【Methods】 The rate of "one-time yield" in BPS of 2018 was calculated and the influencing factors were analyzed. Such influencing factors as air release after leukodepletion, poor performance of leukodepletion filter, selection of blood bag barrel, cup filling method, standing time after centrifugation, separation method were improved in 2019, and the difference of the "one-time plasma yield" rate of fresh frozen plasma/frozen plasma and the centrifugal damage before and after the improvement were compared. 【Results】 After the improvement, the rate of "one-time yield" of fresh frozen and frozen plasma increased to 89% and 80%, respectively, which was significantly increased as compared with that before(P<0.05); the centrifugal damage rate decreased to 0.01%, showed no statistical significance compared with that before. 【Conclusion】 With accurate analysis of the factors affecting "one-time plasma yield", the improved method proved to be effective, the rate of "one-time yield" has been improved significantly, and the blood quality has been guaranteed.

Objective: To evaluate the application of the expanded free deltopectoral flap, pedicled with perforation of internal thoracic artery, in the repairment of middle to large facial skin and soft tissue defect. Methods: From June 2015 to December 2017, 11cases diagnosed with facial lesions were included in this study. The tissue defect of 10 cases were caused by burn, and 1 case by superficial tumor. In the first stage, the tissue expander was implanted into the internal thoracic artery supplying area. After the expander was fully expanded, the second surgery, i. e. the resection of facial lesion, was performed. The defect areas of patients, with the range of 9 cm×7 cm to 17 cm×10 cm, were repaired by expanded free deltopectoral flaps. Results: All flaps were survived, with no vascular crisis occurred. The size of flaps ranged from 10.0 cm×9.0 cm to 18.0 cm×11.5 cm. All the patients were satisfied with the outcomes, after 6 to 24 months follow-up. The color and texture of flaps was close to normal. The scars were acceptable. Conclusions The expanded free deltopectoral flap, pedicled with the perforator of internal thoracic artery, is a promising way to repair middle to large facial skin and soft tissue defect.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Objective: To evaluate 3D imaging technology in the preoperative evaluation of breast conserving surgery. Methods: A ret-rospective analysis was conducted using clinical data from 38 patients who underwent breast conserving surgery that was assisted by 3D imaging technology in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from April 2017 to January 2019. All 38 patients underwent 3.0-T breast magnetic resonance imaging (MRI) examination before surgery, and 3D reconstruction of virtu-al images was constructed through 3D modeling of medical digital imaging and communication (DICOM) data. The predicted resected tissue volume was compared with the volume of the actual resected specimen, and the surgical margin and postoperative aesthetics of the breast conserving surgery were evaluated. Results: The reconstructed 3D model clearly displayed the anatomical structures of the breast, tumor, gland, and blood vessels, and their relationship in 3D spaces. The goodness of fit of the 3D model to the practical sit-uation was 97.4% (37/38). In terms of the resection tissue volume, there was no significant difference between the predicted results (PRTV) and actual results (ARTV) [(61.7 ± 20.1) mL vs. (65.1 ± 20.7) mL, P>0.05]. There was a strong positive correlation between ARTV and PRTV (P<0.01). One patient underwent supplementary secondary surgery, resulting in an incidence of 2.6% (1/38). The postopera-tive satisfaction for breast conserving surgery was 100% (38/38). Conclusions: 3D imaging technology clearly displays the anatomical relationship between breast tumor and surrounding tissues, and correctly assesses breast volume, guiding surgical resection.

Objective To summarize the initial treatment experiences of SNM on non-neurogenic,non-obstructive dysuria during short follow-up.Methods From January 2013 to May,2017,28 patients with non-neurogenic,non-obstructive dysuria who were diagnosed by video-urodynamic study (including 20 male patients and 8 female patients;17 patients suffered from urethra sphincter spasm and 11 from idiopathic detrusor weakness) were recruited in our study.All of them received ⅠnterStim sacral neuromodulation treatment.We tried to compare the data (such as frequency in 24 hours,residual urine,dysuria degree,nocturia,average volume and urgency) before operation and the data of short term follow-up after stage Ⅱ implanted pulse generator (IPG) embedded in order to summarize the initial experiences of sacral neuromodulation for non-neurogenic,non-obstructive dysuria.Results All 28patients received stage Ⅰ operation with percutaneous approach to implant a tined lead,11 patients (8 male patients and 3 female patients) finally removed the tined lead because of poor testing effects.17 patients (12 male patients and 5 female patients) choose embedding IPG at the end of stage Ⅰ.Of all these patients,the conversion rate of stage Ⅰ to stage Ⅱ is 60.7％ (17/28),among them,the conversion rate of urethra sphincter spasm is 64.7％ (11/17) and the conversion rate of idiopathic detrusor weakness is 54.5％ (6/11).The follow-up time after stage Ⅱ was16.7 months (10-46 months).The data of voiding frequency in 24 hours,residual urine,dysuria degree,nocturia,urgency,average voiding amount and quality of life (QOL) between baseline (before stage Ⅰ) and at the follow-up time were 16.3 ± 6.1 vs.8.8 ± 4.1 (P =0.000),(43.0 ± 73.4) ml vs.(37.867.1)ml(P=0.178);7.8 ±2.3vs.4.3 ±1.2(P=0.001);4.0± 1.8 vs.2.5 ±1.7(P=0.003),3.1±1.7vs.1.9±1.1(P=0.001),(145.7 ±73.5)ml vs.(189.0±66.4)ml(P=0.48),5.7vs.1.4 (P ＜ 0.05) and 5.4 ± 0.7vs.4.0 ± 1.0 (P =0.000),respectively.During the follow-up period,11 patients satisfied with symptoms relieve without recurrence.Six patients had symptoms recurrence,4/6 patients regain the effects after reprogramming,but two patients remained serious recurrence even after repeated reprogramming(frequency,dysuria and hesitation recurred as before SNM).Conclusions SNM is an effective,safe and minimally invasive procedure for patients with non-neurogenic,non-obstructive dysuria.Primary,non-neurogenic urinary sphincter spasm is a good indication for SNM and had high transfer rate.