Objective Three-dimension (3D) cell matrix adhesion in vivo is fundamentally important for a wide variety of cellular physiological and pathological phenomena, however, the cell-matrix 3D adhesion is hardly observed in vitro. We present the human foreskin fibroblasts (HFF) formed 3D adhesion complexes on the thoroughly acellular human amniotic matrix (TAHAM). Methods TAHAM were produced by suspending digestion with trypsin. The HFF were seeded on 6 well plate, matrigel and TAHAM individually.The light microscope, scanning electronic microscope, immunohistochemistry and immunofluorescence were used to observe the micro-structures and detect the type Ⅰ , Ⅲ, Ⅳ, Ⅵ collagen, laminin, fibronectin, TGF-β1, TGF-β2, FGF of the TAHAM. Phase contrast microscope was engaged to observe the morphology of HFF. The time-lapse CCD and the trace analysis software were employed to prescribe the cell migration. The 3D adhesion foci were identified by the laser confocal microscope. The strain of the TAHAM was tested by the universal mechanical testing instrument. Results The fibers of the TAHAM were intact, type Ⅰ , Ⅲ,Ⅳ, Ⅵ collagen, laminin, fibronectin were positive, TGF-β1, TGF-β2, FGF were negative. HFF had a bipolar extension to form multilayer cell clusters networks and grew into the matrix. All of the seeded cells survived three weeks under regular culture without transfer. On TAHAM, HFF moved in a straight line with a speed of 12 μm/h. α5 integrin (green), paxillin (red) and fibronectin (blue) co localized to form 3D adhesion complexes (white). Conclusion The main molecular components and biomechanical properties is preserved in TAHAM. HFF forms 3D adhesion complexes on TAHAM. Cell morphology and migration of HFF on TAHAM correspond to that under 3D adhesion behavior.

Objective:To explore the risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.Methods:This was a retrospective cohort study. The maintenance hemodialysis patients diagnosed as superior vena cava stenosis ≥50% or occlusion in West China Hospital of Sichuan University from January 1, 2019 to March 31, 2022 were selected. The patients were divided into hypotensive group and non-hypotensive group according to the occurrence of hypotension during non-dialysis period. The differences of general clinical data, cardiac ultrasound parameters and blood biochemical indexes between the two groups were compared. Multivariate logistic regression model was used to analyze the risk factors of hypotension in patients with hemodialysis-related superior vena cava lesions.Results:A total of 202 patients with hemodialysis-related superior vena cava lesions were included, of whom 84 patients (41.6%) developed hypotension during non-dialysis. Compared with the non-hypotensive group, patients in the hypotensive group had longer dialysis age ( Z=2.093, P=0.036), shorter left atrial diameter ( t=2.316, P=0.022), lower aortic valve orifice flow rate ( t=3.702, P=0.001) and serum calcium ( t=2.320, P=0.021), thicker left ventricular posterior wall ( t=3.042, P=0.003), lower proportions of hypertension history ( χ2=9.125, P=0.003), and higher proportion of residual superior vena cava ≤30% or occlusion ( χ2=8.940, P=0.003) and azygous vein opening ( χ2=11.067, P=0.001). Multivariate logistic regression analysis results showed that no history of hypertension ( OR=0.383, 95% CI 0.156-0.943, P=0.037), slow aortic valve orifice flow ( OR=0.207, 95% CI 0.062-0.695, P=0.011) and low blood calcium ( OR=0.236, 95% CI 0.066-0.841, P=0.026) were the independent influencing factors of hypotension in patients with hemodialysis-related superior vena cava diseases. Conclusions:Hemodialysis patients with severe stenosis or occlusion of the superior vena cava during non-dialysis have a higher risk of hypotension. No history of hypertension, slow aortic valve orifice flow, and low blood calcium are the independent risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.

Objective To study and observe the influence of comprehensive rehabilitation intervention on the vertebral parameters and pain substance of patients with lumbar vertebra fracture.Methods A total of 78 patients with lumbar vertebra fracture treated with rehabilitation intervention were selected,and they were randomly divided into control group (routine rehabilitation intervention group) and observation group (comprehensive rehabilitation intervention group),39 cases in each group.The VAS score,Oswestry disability index and vertebral parameters,serum pain related indexes before the intervention and after the intervention were analyzed and compared.Results The VAS score and Oswestry disability index of observation group at different time after the intervention were significantly better than those of control group,the vertebral parameters were significantly better than control group,and serum pain related indexes were significantly lower than control group (P ＜ 0.05).Conclusion Comprehensive rehabilitation intervention can improve the vertebral parameters and pain substance of patients with lumbar vertebra fracture.

Objective To study and observe the influence of comprehensive rehabilitation intervention on the vertebral parameters and pain substance of patients with lumbar vertebra fracture.Methods A total of 78 patients with lumbar vertebra fracture treated with rehabilitation intervention were selected,and they were randomly divided into control group (routine rehabilitation intervention group) and observation group (comprehensive rehabilitation intervention group),39 cases in each group.The VAS score,Oswestry disability index and vertebral parameters,serum pain related indexes before the intervention and after the intervention were analyzed and compared.Results The VAS score and Oswestry disability index of observation group at different time after the intervention were significantly better than those of control group,the vertebral parameters were significantly better than control group,and serum pain related indexes were significantly lower than control group (P ＜ 0.05).Conclusion Comprehensive rehabilitation intervention can improve the vertebral parameters and pain substance of patients with lumbar vertebra fracture.

Objective To compare the clinical efficacy and safety between stereotactic ablative radiotherapy (SABR) and surgery in the treatment of early-stage non-small cell lung cancer (NSCLC).Methods A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR (n=73) and surgery groups (n=154).Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test.Chi-square test was adopted to compare the baseline data between two groups.Results All patients completed corresponding treatment.The samples of SABR group and operation group were 74 and 155 cases respectively.The 1-year and 3-year overall survival (OS) rates in the SABR and surgery groups were 97.2％,81.9％ and 96.5％,78.2％ (P=0.603),respectively.The 1-year and 3-year progression-free survival (PFS) rates in the SABR and surgery groups were 90.1％,66.9％ and 89.2％,66.9％ (P=0.565),respectively.The 1-year and 3-year locoregional recurrence free survival rates in the SABR and surgery groups were 92.8％,84.0％ and 96.5％,90.8％ (P=0.133),respectively.The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2％,75.4％ and 89.2％,69.8％ (P=0.095),respectively.Conclusions SABR and surgery yield similar OS,PFS,locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC.Therefore,SABR is an alternative treatment for patients with early-stage NSCLC.

Objective:To understand the satisfaction evaluation of contracted residents with " Internet plus" family doctor services and to explore its influencing factors.Methods:From November to December 2021, a stratified random sampling method was used to select 360 contracted residents who had utilized " Internet plus" family doctor services from community health service centers or township health clinics in various counties, cities, or districts of a city in Shandong Province for on-site questionnaire surveys. The purpose was to understand their awareness and satisfaction with the " Internet plus" family doctor services. At the same time, key informant interviews were conducted with contracted residents according to the principle of intensity sampling and information saturation, to collect their opinions and suggestions on the implementation process and model construction of " Internet plus" family doctor services. Descriptive analysis was performed on the data, and a binary logistic regression model was used to analyze the factors affecting the satisfaction of contracted residents with " Internet plus" family doctor services.Results:352 valid questionnaires were obtained. Among the respondents, 108 (30.6%) were very familiar or relatively familiar with the " Internet plus" family doctor service policy, and 251 (71.3%) expressed a high level of satisfaction with the overall " Internet plus" family doctor service. Gender, monthly income status, frequency of participation in health education activities, and satisfaction with the doctor′s daily service attitude, medical technical level, medical service charge level, and the level of communication between the service team and family members were factors affecting the satisfaction of contracted residents with " Internet plus" family doctor services ( P<0.05). Interview results showed that 38 people (95.0%) believed that there were issues with the current implementation of " Internet plus" family doctor services in China, such as the lack of an effective policy support environment, the need to improve the publicity and mobilization effects of contracting institutions, poor service cognition levels among the population, concerns about service quality, misunderstandings about internet-related concepts, network " panic" caused by electronic fraud phenomena, and cultural level differences among the elderly that limited the use of services. Conclusions:The overall satisfaction of contracted residents with the " Internet plus" family doctor services was relatively good. Various factors affected the satisfaction evaluation of contracted residents. It is important to focus on the differences in service psychological perception among contracted residents with different demographic characteristics, strengthen the construction of service teams and service platforms, and improve the public′s cognition and participation in " Internet plus" family doctor services to promote the continuous development of " Internet plus" family doctor services.