Objective To evaluate the validity and reliability of multi-slice spiral CT (MSCT) in preoperative TNM staging judgment of rectal carcinoma. Methods Three hundred and one patients with rectal carcinoma were diagnosed and treated consecutively in Colorectal and Anal Surgery Department of Shanxi Province Tumor Hospital from January 2009 to December 2009. The clinical data of these patients were analyzed retrospectively. The diagnosis results were compared between the preoperative MSCT staging and the postoperative pathological staging,the ROC curve and the diagnostic concordance test were analyzed by software Medcalc 11.2. Results The sensitivity, specificity, Kappa value, area under the curve of TNM staging were 64.7% ,96. 8% ,0. 667,0. 808 for T2 staging tumors; 93.8% ,75.0% ,0.709,0.844 for T3 staging tumors;87. 8% ,98. 1% ,0. 859,0. 929 for T4 staging tumors; 72. 0% ,91.2% ,0. 619,0. 816 for N staging tumors;92. 7%, 99. 7%, 0. 925,0. 963 for M staging tumors respectively. Conclusion The diagnostic value of independent use of MSCT in estimating the infiltration degree and lymph node metastasis of rectal cancer is very poor and cannot be used in preoperative staging judgment.

Objective To evaluate the effectiveness of several methods in eliminating Mycoplasma contamination in cell culture of human hepatoma-derived cell line C3A. Methods PCR was performed to detect the Mycoplasmas contamination in cell cultures. The contaminated samples were treated by ciprofloxa-cin, heating, Plasmocure or co-culturing with macrophages. Transmission electron microscope ( TEM) and Q-PCR were used to comparatively analyze the cell morphology and gene expression before and after Plas-mocure treatment. Results Plasmocure succeeded in eliminating Mycoplasma contamination, while cipro-floxacin showed temporary efficacy. Heating and co-culturing with macrophages failed to eliminate Mycoplas-ma contamination. No Mycoplasma contamination in the Plasmocure-treated group was observed under TEM and the expression of ALB, TF and CYP3A4 genes were higher than the genes expressed in the contaminated group (P<0. 01). Conclusion Plasmocure treatment was effective in eliminating Mycoplasma contamina-tion in cell culture. Moreover, the cell morphology and gene expression in Plasmocure-treated group were re-stored to normal.

Objective To compare the effect of pedicles screw fixation through entry point of the “人" shape crest and traditional entry point (Weinstein method). Methods Ninety-two patients of lumbar spine disorders were treated by pedicles screw fixation combined with bone grafting through posterior approach. The screws were placed through the traditional entry point among 45 patients (group A, transverse process method, 186 screws), the others were through entry point of the “人" shape crest (group B, “人" shape crest method, 196 screws). The condition of accuracy of screw placement, operation time, bleeding amount and injury were compared. Results All patients accepted the examination of X-ray and CT scan after operation. The rate of screw bad placement was 6.5% in group A and 2.0% in group B, the incidence of injury of nerve and blood vessel was 8.9% in group A and 2.1% in group B. The accuracy of screw placement, operational time and bleeding amount in group B were significantly better than those in group A (P

Objective To explore the in vitro antibacterial effect of tanreqing injection combined with cefuroxime sodium injection against staphylococcus aureus. Methods The MIC of tanreqing injection or cefuroxime sodium injection against staphylococcus aureus was detected by microamount dilution method.The antibacterial activity of tanreqing injection combined with cefuroxime sodium injection was determined by a chess board dilution method and assessed according to FIC index. Results The MIC of tanreqing injection and cefuroxime sodium injection against staphylococcus aureus was 1∶256 and 2 μg . mL-1 , respectively. While combined with each other, the MIC of tanreqing injection and cefuroxime sodium injection against staphylococcus aureus was 1∶4 096 and 0. 125 μg . mL-1 , respectively. The FIC index of tanreqing injection combined with cefuroxime sodium injection against staphylococcus aureus was 0. 125. Conclusion Tanreqing injection has a synergistic antibacterial effect against staphylococcus aureus when it was combined with cefuroxime sodium injection.

Objective To study the clinical efficacy of external fixator and combined screwing at iliac crests and pubic symphysis for the treatment of unstable pelvic fractures.Methods From January 2013 to February 2014,12 cases of unstable pelvic fracture were treated at our department.They were 8 men and 4 women,from 32 to 57 years of age (average,42.5 years).Seven cases were caused by a traffic accident,and 5 by falling from a height.By Tile classification,8 cases were type B (including type B1 in 3 cases,type B2 in 3 and type B3 in 2),and 4 cases type C1.Associated injury included shock in 7 cases,bladder injury in one,limb long bone fracture in 6,joint injury in 3,and thoracic and lumbar injury in 4.The interval from injury to operation averaged 4 days,ranging from 12 hours to 7 days.The type B fractures were treated with an external fixator and combined screwing at iliac crests and pubic symphysis while the type C1 fractures with internal fixation with percutaneous S1 sacroiliac screws in addition to what was used for the type B fractures.Results The 12 patients were followed up for 5 to 12 months(average,9 months).No one died in this group.The fractures healed after 8 to 13 weeks (average,11.3 weeks).All the patients recovered normal walking.Superficial infection at the pin hole occurred in 7 cases,but there was no deep infection.Screw loosening was observed in only one case,and no reduction loss,injury to nerves or urinary canal was observed.According to the Majeed criteria,the efficacy was evaluated as excellent in 10 cases,good in one,and moderate in one.Conclusion External fixator and combined screwing at iliac crests and pubic symphysis can restore the stability of anterior pelvic ring,leading to good clinical outcomes.

An improved everted gut sac method was applied to the study of prescription compatibility effect on the major components in Danshen extracts. With the separation and detection by HPLC-ECD, 5 major peaks could be detected in intestinal absorbed solution after prescription administration. Following the identification by HPLC-MS/MS, peak 2, 3, 4, and 5 were rosmaric acid, lithospermic acid, salvianolic acid B, and salvianolic acid A, respectively, which also confirmed with reference standards of those components. Through paralleling substance identification, peak 2, 3, 4, and 5 could be found as the major components in Danshen extracts, except Salvianolic acid E which is undetectable in intestinal solution. The contents of peak 2, 3, and 4 did not show difference before and after compatible prescription administrated, where the peak 5 had a significant increase in the same process. Those results revealed that peak 5, salvianolic acid A, might lead to an increasing pharmacological effect after prescription compatibility.

Objective: To observe the effects of follistatin (FST)on the skeletal muscle wasting of cancer cachexia mice and the expressions of Mstn, LncRNA-MALAT1 and Caspase-3, and to elucidate its associated molecular mechanisms.Methods:Thirty-two BALB/c mices were randomly assigned into:healthy control (HC) group,FST prevention (FP)group,FST treatment (FT)group and cancer cachexia (CC)group.The murine colon adenocarcinoma CT26 cells were inoculated subcutaneously into the mices in FP, FT and CC groups to establish the cancer cachexia models. The body weight, spontaneous activity and tumor growth were daily monitored.The mice in FP and FT groups were administrated with FST intraperitoneally on day 6 and 12 after inoculation.The samples were collected on day 20.The tumor and gastrocnemius weights of the mice were detected. The biochemical metabolism indexes and myofiber cross-sectional area of gastrocnemius tissue were detected.The mRNA expression levels of Mstn,Caspase-3 and LncRNA-MALAT1 were examined by Real-time PCR.The protein expression levels of Mstn and Caspase-3 were measured by Western blotting method. Results:Compared with CC group,the body weights,spontaneous activities,gastrocnemius weights and myofiber cross-sectional areas were increased (P <0.05);the serum levels of glucose,total protein and albumin of the mice in FP and FT groups were increased (P <0.05).The protein and mRNA expression levels of Mstn and Caspase-3 in gastrocnemius of the mice in CC group were significantly higher and the expression level of LncRNA-MALAT1 was significantly lower than those in HC group (P < 0.05).The mRNA and protein expression levels of Mstn and Caspase-3 in FP and FT groups were reduced and the expression level of LncRNA-MALAT1 was increased compared with CC group (P < 0.05).The prevention effect in FP group is better than FT group (P < 0.05). Conclusion:FST may alleviate the muscle wasting of the mice with cancer cachexia by inhibiting the expression of Mstn,thus upregulating the expression of LncRNA-MALAT1 which in turn to suppress the expression of Caspase-3.

Adult ; Autonomic Dysreflexia ; therapy ; Cesarean Section ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; therapy ; Spinal Cord Injuries ; complications

Cardiovascular surgery patients have complex and changeable conditions, and the nursing operation is highly specialized, and involves the use of a variety of high-precision instruments and high-risk drugs. Therefore, it's not only required that teachers should have solid theoretical knowledge, rich clinical experience, and good moral quality, but nursing interns also need to have active learning consciousness, adapt to the work intensity of the department in a short time and be familiar with the work content. Starting from the difficulties of clinical nursing teaching in cardiovascular surgery, this study puts forward measures such as attaching importance to the mobilization of nursing students before internship, strengthening the standardized management of clinical teaching, introducing diversified nursing teaching methods, and paying attention to the mental health of intern nurses during the practice, so as to improve the quality of nursing teaching.

Objective To explore the predictive value of glucose metabolism and lipid metabolism indexes for in-stent restenosis(ISR)in patients with arteriosclerosis obliterans(ASO)of lower limbs after surgery.Methods A total of 160 patients with ASO of lower limbs admitted to the Second Affiliated Hospital of Zhengzhou University and Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to October 2021 were selected as the research subjects.All patients were treated with percutaneous transluminal angioplasty combined with stent implantation and were followed up for 1 year.Patients were divided into the ISR group(n=59)and the non-ISR group(n=101),according to the incidence of ISR during the follow-up period.General clinical data of patients in the two groups were collected.Univariate analysis was performed to preliminarily screen out the influencing factors for ISR,and the selected indexes were further analyzed by multivariate logistic regression to analyze the influencing factors for the occurrence of ISR in patients with ASO of lower limbs after surgery.The receiver operating characteristic(ROC)curve was used to analyze the value of the glucose metabolism and lipid metabolism indexes one day before discharge alone and their combination in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery.The net benefit rate of predicting the occurrence of ISR in patients with ASO of lower limbs by the levels of glucose metabolism and lipid metabolism indexes one day before discharge alone and their combination was analyzed through the decision curve.Results Among the 160 patients,59 developed ISR,with an incidence rate of 36.88％.There was no significant difference in age,gender,alcohol consumption,complications,affected side,Fontaine stage,fasting plasma glucose,and serum triglycerides of patients between the ISR group and the non-ISR group(P＞0.05);the proportion of smokers and the levels of glycosylated hemoglobin A1c(HbA1c)in peripheral blood and low-density lipoprotein(LDL)in serum of patients in the ISR group were significantly higher than those in the non-ISR group,while the level of high-density lipoprotein(HDL)in serum was significantly lower than that in the non-ISR group(P＜0.05).Multivariate logistic regression analysis showed that the elevated levels of HbA1 c in peripheral blood and LDL in serum were risk factors for ISR in patients with ASO of lower limbs after surgery(odds ratio＞1.00,P＜0.05),and the increased level of HDL in serum was the protective factor for ISR in patients with ASO of limbs after surgery(odds ratio＜1.00,P＜0.05).The ROC curve showed that the area under the curve of peripheral blood HbA1c,serum LDL and HDL levels alone and their combination in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery was 0.717,0.761,0.654,and 0.824,respectively;the specificity was 0.861,0.792,0.851,and 0.663,respectively;and the sensitivity was 0.525,0.678,0.424,and 0.864,respectively.The decision curve showed that the net benefit rate for the combination of peripheral blood HbA1c,serum LDL and HDL levels one day before discharge in predicting the occurrence of ISR in patients with ASO of lower limbs after surgery was higher than that of prediction by the said indexes alone.Conclusion Glucose metabolism index peripheral blood HbA1c and lipid metabolism indexes serum LDL and HDL have certain predictive values for the occurrence of ISR in patients with ASO of lower limbs after surgery,and the net benefit rate of the joint prediction of the three indexes is higher.