Objective To evaluate the PDCA cycle on the rehabilitation of postoperative patients with anal fistula, aiming at improving the recovery of patients and preventing recurrence. Methods 144 postoperative patients of anal fistula were randomly divided into the observation group and the control group with 72 cases in each group. The observation group received intervention based upon the PDCA cy-cle, and the control group was given the traditional oral propaganda. The recovery time, recurrence rate, mastering of education content and self-control ability were compared in the two groups using t test and χ2 test. Results The mastering level of education content and the self-management skills in the observation group were superior to those of the control group. After 3 to 24 months of follow-up, the observation group showed shorter recovery time and less recurrence rate than that of the control group. Conclusions Nurs-ing intervention based upon PDCA cycle can strengthen the patients' mastering of related knowledge, pro-mote the recovery, reduce recurrence rate and improve the patients' quality of life.

Bile acid as a signaling molecule can specifically bind to bile acid receptors (such as farnesoid X receptor and G-protein-coupled bile acid receptor) to mediate a series of biological regulation reactions. In recent years, it has been found that bile acids are widely involved in glucose metabolism, lipid metabolism and energy metabolism. The development of metabolic diseases is usually accompanied by the changes of bile acid profiles and receptors, and thus bile acids may be applied as potential biomarkers for clinical diagnosis, prediction, and evaluation of therapeutic effects. This article reviews the relationship between bile acids and metabolic diseases, and the treatment of metabolic diseases based on the regulation of bile acid metabolism.

Objective To investigate the dynamic changes of serum insulin-like growth factor-1 (IGF-1) in acute traumatic brain injury (TBI) as well as their correlations with the initial severity of TBI and prognosis.Methods A total of 229 patients with acute TBI admitted from September 2014 to June 2016 were retrospectively studied.Patients were further classified as mild TBI group (GCS 13-15 points),moderate TBI group (GCS 9-12 points) and severe TBI group (GCS 3-8 points) according to Glasgow coma score (GCS).The control group consisted of 30 healthy subjects.The prognosis was evaluated by using Glasgow outcome scale (GOS) at 6 months after TBI.The IGF-1 levels were further tested at days 1,3,5,7 and 14 and their correlations with the initial GCS and GOS at 6 months after injury were evaluated.Results (1) The serum IGF-1 levels of mild,moderate and severe TBI group at all time points were significantly lower than those of the control group (P ＜ 0.05);the serum IGF-1 levels of severe and moderate TBI groups at all time points after injury were significantly lower than those of the mild TBI group (P ＜0.05);the serum IGF-1 levels of the severe group at days 1,3,5 and 7 d after injury were lower than those of the moderate TBI group (P＜0.05).(2) IGF-1 levels were significantly different between the two groups (P ＜ 0.05) at different time points during the follow-up of 6 months.(3)IGF-1 levels were positively correlated with both GCS and GOS at the acute stage of TBI and sub-acute stage following TBI (P ＜ 0.05).Conclusion The dynamic changes of serum IGF-1 levels in patients with acute TBI are related to both initial severity of TBI and the neurological outcomes and can be used as a reliable biomarker for early severity assessment and prognostic prediction of TBI.

Objective: To investigate the value of MRI in the early diagnosis of diagnosis of dysbaric osteonecrosis. Methods: Labor hygiene investigation and occupation health were examined on 52 high pressure operating personnel, were selected for the examination of both shoulders, hips and knees with X-ray and CT scan. Results: The cystic sign in dysbaric osteonecrosis as an important imaging feature, which perform in the MRI examination for T1W I sequence showed low or slightly low signal and T2W I sequence showed high signal, and X-ray and CT have a lower detection rate than MRI. The Kappa consistency test showed a high consistency with the two methods. At the same time MRI examination also can discover the bone marrow cavity necrosis early pathological change. Conclusion MRI is an effective method for the diagnosis of early dysbaric osteonecrosis, which can improve the early diagnosis rate of dysbaric osteonecrosis.

The present study was carried out to investigate the effect of antisense c-myb oligodeoxynucleotides (ODN) on hCG-induced testosterone secretion in isolated rat Leydig cells. The effects of cAMP, Ca(2+) and cycloheximide (CYX) on c-Myb protein expression and testosterone secretion were also observed. The results showed that antisense c-myb ODN inhibited hCG-induced testosterone secretion of isolated rat Leydig cells in a dose-dependent manner. At the same time, integral optical density immunostaining of Myb in Leydig cells was also remarkably reduced. Nonsense tat ODN had no effect on Leydig cells. Further experiments showed that dbcAMP (100 micromol/L) obviously increased hCG-induced testosterone secretion and integral optical density (IOD) immunostaining of Myb in Leydig cells. Verapamil (10 micromol/L), a Ca(2+) channel blocker, and cycloheximide (50 microg/ml), a protein synthesis inhibitor, reduced the immunostaining of c-Myb, and also lowered hCG-induced testosterone secretion in isolated rat Leydig cells. The results indicate that c-myb closely correlates with hCG-induced testosterone secretion, and that cAMP and Ca(2+)-dependent pathway participates in the expression of protooncogene.
Animals ; Cell Separation ; Cells, Cultured ; Chorionic Gonadotropin ; pharmacology ; Leydig Cells ; secretion ; Male ; Oligodeoxyribonucleotides, Antisense ; physiology ; Proto-Oncogene Proteins c-myb ; physiology ; Rats ; Rats, Sprague-Dawley ; Testosterone ; secretion

OBJECTIVE: To explore the genetic basis of a Chinese pedigree affected with Dyggve-Melchior-Clausen syndrome. METHODS: Whole exome sequencing and Sanger sequencing were carried out to detect potential pathogenic variants associated with the syndrome. The function of candidate variant was verified by Western blotting. RESULTS: A novel homozygous variant, c.1222delG of the DYM gene was detected in the two affected siblings, for which both parents were heterozygous carriers. The variant has caused replacement of Asp by Met at amino acid 408 and generate a premature stop codon p.Asp408Metfs*10. Western blotting confirmed that the variant can result in degradation of the mutant DYM protein, suggesting that it is a loss of function variant. CONCLUSION The homozygous c.1222delG frameshift variant of the DYM probably underlay the Dyggve-Melchior-Clausen syndrome in the two affected siblings. Above findings has enabled clinical diagnosis and genetic counseling for the family.
China ; Dwarfism/genetics* ; Humans ; Intellectual Disability ; Osteochondrodysplasias/genetics* ; Pedigree

Objective Based on computational fluid dynamics (CFD) method, the air and aerosol transport in a single alveolus were simulated to study the characteristics of airflow and aerosol transport in deep alveolus. Methods A long straight duct with a hemispherical wall at one end which had periodic expansion/contraction were regarded as simplified approximation of a single alveolus. Based on this, a two-dimensional (2D) mathematical model was established.The Euler-Euler method was used to solve the transport equations of airflow and aerosol particles in the alveolus considering air diffusion along the hemisphere boundary. Results The composition ratio of the air in the duct changed in a stable periodic way during the whole breathing process.The aerosol transport in the duct mainly depended on the particle diffusion coefficient. The advection transport had only a small effect on it. The diffusion velocity and depth of aerosol increased when the particle size decreased, especially when the particle size was smaller than 4 μm. The increase of respiratory frequency and amplitude could significantly improved the transport capacity of aerosol particles. Conclusions In atomization treatment, aerosol particles with smaller particle size have better transportation and curative efficacy. Deep breathing should be encouraged to improve particle transport.

Objective: To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method. Methods: The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation. Results: The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P<0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators. Conclusion The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.

BACKGROUNDThe aim of this study was to assess the performance of apparent diffusion coefficient (ADC) measurement obtained with diffusion-weighted magnetic resonance imaging (DW-MRI) to distinguish renal cell carcinomas (RCCs) from small benign solid renal tumors (≤ 4 cm).

METHODSIn this cross-sectional study, 49 consecutive patients with histopathologically confirmed small solid renal tumors, and seven healthy volunteers were imaged using nonenhanced MRI and DW-MRI. The ADC map was calculated using the b values of 0, 50, 400, and 600 s/mm 2 and values compared via the Kruskal-Wallis and Mann-Whitney tests. The utility of ADC for differentiating RCCs and benign lesions was assessed using a receiver operating characteristic curve. Multiple nonenhanced MRI features were analyzed by Logistic regression.

RESULTSThe tumors consisted of 33 cases of clear-cell RCCs (ccRCCs) and 16 cases of benign tumors, including 14 cases of minimal fat angiomyolipomas and 2 cases of oncocytomas. The ADCs showed significant differences among benign tumors ([0.90 ± 0.52] × 10-3 mm 2 /s), ccRCCs ([1.53 ± 0.31] × 10-3 mm 2 /s) and the normal renal parenchyma ([2.22 ± 0.12] × 10-3 mm 2 /s) (P < 0.001). Moreover, there was statistically significant difference between high and low-grade ccRCCs (P = 0.004). Using a cut-off ADC of 1.36 × 10-3 mm 2 /s, DW-MRI resulted in an area under the curve (AUC), sensitivity, and specificity equal to 0.839, 75.8%, and 87.5%, respectively. Nonenhanced MRI alone and the combination of imaging methods led to an AUC, sensitivity and specificity equal to 0.919, 93.9%, and 81.2%, 0.998, 97%, and 100%, respectively. The Logistic regression showed that the location of the center of the tumor (inside the contour of the kidney) and appearance of stiff blood vessel were significantly helpful for diagnosing ccRCCs.

CONCLUSIONSDW-MRI has potential in distinguishing ccRCCs from benign lesions in human small solid renal tumors (≤ 4 cm), and in increasing the accuracy for diagnosing ccRCCs when combined with nonenhanced MRI.

Adult ; Aged ; Carcinoma, Renal Cell ; diagnosis ; Cross-Sectional Studies ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the pre-post operational change of argyrophilic-nucleolar organizer regions (Ag-NORs) in peripheral T-lymphocyte of patients with gastric carcinoma (GC), and to explore the effect of shenqi fuzheng injection(SFI) on it.

METHODSEighty five patients were divided into two groups according to the operation performed was radical or non-radical, and the two groups were subdivided into two by additional intravenous dripping of SFI was given to them or not. The content of Ag-NORs in peripheral T-lymphocyte in all patients before and after operation as well as in 12 healthy subjects was determined.

RESULTSContent of Ag-NORs in GC patients was significantly lower than that in the healthy subject (P < 0.01), which significantly increased after patients underwent radical operation (P < 0. 01 or P < 0.05), especially in those treated with SFI (P < 0.01). While in patients underwent non-radical operation but not treated with SFI, it showed insignificant change after operation, however it did significantly increase in those treated with SFI (P < 0.05).

CONCLUSIONThe immune function of T lymphocyte was low in patients with gastric carcinoma, post-operational adjuvant treatment of SFI can significantly improve the cellular immunity of patients.

Adjuvants, Immunologic ; therapeutic use ; Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Injections ; Male ; Middle Aged ; Nucleolus Organizer Region ; metabolism ; Phytotherapy ; Silver Staining ; Stomach Neoplasms ; drug therapy ; immunology ; surgery ; T-Lymphocytes ; immunology