Objective:To establish a complete set of EMPI system and service, resolve the problems of Patient information is inconsistent and medical data difficult to share.Methods: After analysis patient basic information management module of business systems, Propose a solution of “using IHE ITI-PIX V3 to build EMPI”.Result: By establishing master patient index and provide services to each system to be called, has realized the patients basic information integration, and on this basis to realize Hospital-wide electronic medical records.Conclusion:Without change the original business system, through the pix implementation master patient index associated with patient's id in each business system, meet the needs of patient information sharing.

BACKGROUND:Studies have shown that human cartilage glycoprotein-39 has a certain relationship to articular cartilage degeneration and repair, but the mechanism of action is not very clear. OBJECTIVE:To investigate the effect of human cartilage glycoprotein-39 on chondrogenesis of precartilaginous stem cels. METHODS: Precartilaginous stem cels were isolated from the adult articular cartilage. Cels which could express CD105 and CD166 were detected using flow cytometry folowed by isolation and purification. Isolated precartilaginous stem cels werecultured using monolayer method, and then, passage 2 cels were cultured in the medium containing human cartilage glycoprotein-39 and normal chondrogenic medium for 14 days, respectively. Immunohistochemical staining was used to observe expression of type II colagen and gross observation was done for evaluation of cartilage formation. RESULTS AND CONCLUSION:The precartilaginous stem cels isolated from the adult articular cartilage could express CD105 and CD166. After induction, differentiated precartilaginous stem cels gradualy gathered and formed nudes. The induced cels were positive for type II colagen; after induction by human cartilage glycoprotein-39, the nodules became larger and the expression of type II colagen was increased. These findings indicate that precartilaginous stem cels with chondrogenic ability can be isolated from the adult articular cartilage, and can be induced to differentiate into chondrocytes, in which human cartilage glycoprotein-39 plays an important role.

BACKGROUND:Previous studies have confirmed that ethanol can promote adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and up-regulate the expression of PPARγ and aP2 in the tumor necrosis factor α (TNF-α) signaling pathway. As a member of the ZIP protein family, Zrt/Irt-like protein 1 (ZIP1) is closely related to bone metabolism and osteogenic differentiation.OBJECTIVE:To study the effect of BMSCs transfected by ZIP1 on TNF-α signaling pathway in the process of adipogenic differentiation.METHODS:The BMSCs from rabbits were isolated and cultured under different concentrations of alcohol (0.03, 0.09,0.15, 0.21 mol/L), followed by transfection by ZIP1 siRNA and ZIP1 expression vector.RESULTS AND CONCLUSION:After culture in alcohol, the expression levels of aP2 and PPARγ proteins were both significantly increased (P < 0.05), and the level of triglyceride was increased in all alcohol groups except for 0.03 mol/L alcohol group (P < 0.05). After siRNA transfection, the expression levels of aP2 and PPARγ as well as the level of triglyceride were increased significantly in all the alcohol groups (P < 0.05); however, ZIP1 transfection decreased the expression levels of aP2 and PPARγ proteins (P < 0.05). To conclude, ZIP1 siRNA could promote the adipogenic differentiation of BMSCs through the activation of TNF-α signaling pathway.

Objective To construct eukaryotic expression vector of wild type E 4F1 and the mutant deleting amino acid region 32-81, and to detect the interaction between wild type or mutant E 4F1 and p53 and to study the effect of E4F1 on the expression level of p21.Methods Wild type and mutant sequences of E 4F1 were amplified from the mammary library using standard PCR and recombinant PCR .The sequences were cloned into pXJ 40-MYC vector to generate the MYC-E4F1 and MYC-E4F1(Δ32-81) recombinant plasmids that were transfected into 293T cells and identified by Western blotting . FLAG-p53 and MYC-E4F1 or MYC-E4F1(Δ32-81) were co-transfected into 293T cells and immunoprecipitation assay was performed to detect the interaction of wild type or mutant E 4F1 with p53.Wild type and mutant E4F1 expressing vec-tors were co-transfected into osteosarcoma U2OS cells and the expression of p21was detected.Results Recombinant plas-mids of MYC-E4F1 and MYC-E4F1(Δ32-81) were successfully constructed.Both wild type and mutant E4F1 interacted with p53.Deletion of amino acid region 32-81 of E4F1 increased the interaction .The expression level of p21 was in-creased by wild-type E4F1, but not by mutant E4F1.Conclusion The eukaryotic expression vector of wild type E4F1 and its deletion mutant is successfully constructed .Both of them interact with p53.Deletion of amino acid region 32-81 of E4F1 increases the interaction .This study contributes to further studies on the regulation and mechanism of E 4F1 on p53.

Objective:To explore the feasibility and clinical effect of modified tibial transverse transport (TTT) technique in treatment of severe diabetic foot.Methods:The research was carried out from November 2015 to November 2017 at the Department of Hand Microsurgery, Xiangya Hospital of Central South University. Red latex was used to perfuse 10 adult lower limb specimens through femoral artery. The study observed the occurrence rate of osteofascial cutaneous branches from the inner and posterior edge of tibia within 6.0 to 10.0 cm distal from the tibial tubercle, as well as the number, distribution, outer diameter and other indicators of the perforating cutaneous branches and periosteal branches. Combined with findings in the anatomical observation, a chimeric flap with a vessel of posterior medial tibial osteofascial cutaneous branch was designed to improve TTT in the treatment of diabetic foot. From February 2016 to November 2018, 12 patients with Wagner’s Grades Ⅲ and Ⅳ diabetic feet were treated. All the patients were treated with a modified TTT, with a piece of designed tibial bone flap at 10.0 cm × 2.5 cm in size. After surgery, 5 patients with gangrenous toes received various toe stump reconstruction surgery for removal of the external fixator for bone transport. Two patients had arch stone flap reconstructions for the wounds of heel and sole, 3 patients had the wounds self-healed, and 2 patients with Wagner’s Grade IV diabetic feet had proximal calf amputations. Postoperative follow-ups were run through visits of outpatient clinic, and meanwhile the preliminary effects of the surgical procedure were observed and summarised.Results:Among the 10 specimens, it was found that a total of 11 osteofascial cutaneous branches(2 branches in 1 case and 1 branch in 9 cases) branched out from the posterior edge of tibia within 6-10 cm distal to the tibial tubercle. The distance to the tibial tubercle was 9.23 cm± 0.62 cm, with an outer diameter at 1.10 mm ± 0.10 mm. After penetrating the deep fascia, the osteofascial cutaneous branch further branched out a skin branch with an outer diameter of 0.59 mm± 0.09 mm, and delivered blood supply to the medial skin of calf. Meanwhile, it also branched out a periosteal branch with an outer diameter of 0.85 mm ± 0.10 mm, and supplied blood to the medial periosteum of tibia. All surgery went smoothly. A significant increase of temperature in foot skin and a significant decrease in postoperative Visual Analogue Scale(VAS) score were found in comparison with what before the surgery( P<0.05). The follow-up time of 12 patients was 24-36(29.33 months ± 4.36 months). After surgery, the symptoms of pain and numbness in the affected limbs were significantly improved or even disappeared and the wounds in foot were completely healed in 10 patients. The wounds of TTT in the calf were all healed in stage-I. The segments of tibial bone transport were all completely healed with healing time of 6.17 months ± 0.83 months. The wounds of the 2 amputees healed well. Conclusion:Modified TTT bone graft can effectively promote wound healing and reduce complications by covering the wound with a posterior tibial medial fascia flap in the treatment of severe diabetic foot. Further studies are required to confirm the benefits to the patients from this modified surgical procedure.

Objective To explore the risk factors and nursing intervention for pneumothorax in performing CT-guided radioactive 125I seed implantation in patients with lung cancer.Methods 40 patients with lung cancer who performed CT-guided radioactive 125I seedimplantation from January 2014 to November 2015 were included in the study. The retrospective analysis was used and the participants were hospitalized either in Peking university third hospital or in Hebei Cangzhou hospital of integrated traditional Chinese and western medicine. Results After the implantation, seven patients had implantation including five mild cases and two moderate cases. Six patients got better after the implantation (i.e. five of them had no obvious clinical symptoms and one of them had chest distress and cough). One case had hemothorax combined with chest distress and cough, but got better after air extraction and closed thoracic drainage.Conclusions The risk factors for pneumothorax in performing CT-guided radioactive 125I seed implantation may include the type and location of the lesion and the number of puncture times. The important factors for preventing the incidence of pneumothorax may include preoperative analysis of the type and location of lesions, reducing thepuncture times, less harm for pleural layers,and reasonable needlepoint. The major nursing strategies to prevent pneumothorax include preoperative evaluation and health education, cooperate with the doctors during the operation,and close observation of patients'postoperative symptoms.

Objective:To explore the application effect of information sharing assisted decision-making intervention in knee replacement patients.Methods:A total of 94 inpatients undergoing knee replacement in Department of Orthopedics in Xinxiang Central Hospital from January to December 2022 were selected by the convenient sampling method, and they were divided into the control group and the observation group according to random number table method, with 47 cases in each group. The control group adopted routine clinical decision-making management, while the observation group implemented information sharing assisted decision-making intervention based on the control group. On the 5th day after surgery, Control Preference Scale (CPS), Chinese version of Preparation Decision Making Scale (PreDM) and Decision Participation Satisfaction Scale were used to evaluate the decision participation, decision readiness and decision satisfaction of patients in two groups.Results:In the control group, active, cooperative and passive decision-making participation accounted for 21.28% (10/47), 27.66% (13/47) and 51.06% (24/47), respectively. In the observation group, 42.55% (20/47), 44.68% (21/47) and 12.77% (6/47) of the participants were active, cooperative and passive, respectively. There was a statistically significant difference in the distribution of decision participation between the two groups ( P<0.01). The PreDM score and decision participation satisfaction score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Information sharing assisted decision-making intervention can effectively improve the decision-making participation of knee replacement patients and improve their decision-making readiness and satisfaction.