Objective To evaluate the influence of international normlized ratio(INR) self-management intervention on the complication of patients after mechanical heart valve replacement (MHVR).Methods The randomized controlled trials (RCT) about comparing the INR self-management with conventional management in patients after MHVR were researched by the database of PubMed, Medline, China Biomedical Literature Database, Wanfang data, Chinese National Knowledge Infrastructure, and the data were analyzed by Stata 12.0 software.Results Nine RCTs were enrolled in this study, 4 265 cases in total.The results of Meta-analysis showed that INR self-management could reduce the incidence of thrombosis, relative risk(RR) was 0.68, 95％ confidence interval (95％CI) was 0.50-0.94, P＜0.05.However, there was no significant difference in hemorrhage between the two groups, yet could not evaluate the effect on INR values within the target range, RR(95％CI) was 1.29(1.20-1.38), P＜0.05.But due to the high heterogeneity in literature, the results were for reference only, it remained to be further argumen.Conclusions INR self-management can reduce the incidence of thrombosis in patients after mechanical heart valve replacement, and does not increase the risk of bleeding complication at the same time.

Objective To investigate the cognition and participation on organ donation in ICU medical staff and analyze the influencing factors, thus to provide reference for the development organ donation promotion measures. Methods 265 ICU medical staff were chosen by convenient sampling method from 10 three-level hospitals in Chongqing and were investigated with a self-designed questionnaire about the cognition, willingness and its influencing factors towards organ donation. Results ICU medical staff′s understanding of brain death, significance, basic conditions and concepts of organ donation were 67.2% (178/265), 61.1% (162/265), 60.0% (159/265), 55.8% (148/265) respectively, but understanding of Principles , registration methods, laws and regulations, and procedures of organ donation were 24.5%(65/265), 12.1%(32/265), 7.9%(21/265), 4.5%(12/265) respectively. 47.5%(126/265) ICU medical staff were willing to donate their own organs, 35.8%(95/265) were consented to relative′s organ donation and 4.5% (12/265) were organ donation applications. 89.1% (236/265) were affected by traditional ethical concepts, 70.2%(186/265) were for the publicity not enough, 51.7%(137/265) did not know about the procedures of organ donation, 37.0%(98/265) were for too much troubled procedures, and 43.8%(116/265) were for the ineffective work of relevant organizations. Conclusions Lacking in-depth understanding of organ donation and low willingness to donate organs in ICU medical staff in Chongqing. Mainly associated with the effect of traditional concept and lack of propaganda to the donation.

OBJECTIVETo determine whether lysosome-associated protein transmembrane-4 beta (LAPTM4B) over-expression is associated with the proliferation and invasion in colorectal cancer (CRC).

METHODSThirty pairs of CRC tissues, containing carcinoma and adjacent tissues, were used for the examination of LAPTM4B mRNA expression by real-time quantitative PCR (qPCR) assays. Then immunohistochemistry was performed to examine LAPTM4B protein expression in 6 pairs of CRC tissues. Over-expression LAPTM4B and low-expression LAPTM4B cell models were constructed with HCT116 CRC cell lines. CCK8 assay was used to detect the proliferation and Transwell assay was used to detect the invasion of the model cells.

RESULTSqPCR and immunohistochemistry results showed that LAPTM4B expression levels in CRC were higher compared to adjacent tissues (all P<0.01). CCK8 and Transwell assays results showed that LAPTM4B promoted proliferation and invasion of HCT116 cell lines model cells (all P<0.01).

CONCLUSIONLAPTM4B promotes the proliferation and invasion in CRC patients, and may be used as an important potential marker.

Cell Proliferation ; Colorectal Neoplasms ; HCT116 Cells ; Humans ; Immunohistochemistry ; Membrane Proteins ; Neoplasm Invasiveness ; Oncogene Proteins

OBJECTIVETo investigate the efficacy of complete mesocolic excision (CME) in the radical operation for right hemicolon cancer.

METHODSClinical data of 336 cases of right hemicolon cancer undergoing radical resection, including 218 cases of CME surgery group and 118 cases of traditional surgery group, from January 2005 to December 2014 in Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed. Intraoperational events, perioperative status and postoperative survival were compared between the two groups.

RESULTSThe baseline information was not significantly different between the two groups (all P>0.05). The number of harvested lymph nodes in CME and traditional group was 11.4±0.3 and 9.3±0.5 respectively(P=0.000) and the proportion of greater than or equal to 12 lymph nodes per case was 47.3%(103/218) and 28.8%(34/118)(P=0.002), which both were significantly different. The operation time in CME and traditional group was (147.2±2.9) and (148.8±3.9) minutes, which was not significantly different (P>0.05), whereas operative blood loss was (125.7±7.5) and (305.1±20.5) milliliters in CME and traditional group with significant difference (P=0.000). Postoperative hospital stay was (12.9±0.9) and (16.3±1.0) days in CME and traditional group with significant difference (P=0.018), while the time to postoperative liquid intake and normal diet was not significantly different between two groups (both P>0.05). The morbidity of postoperative complication of CME group was lower compared to traditional group (14.2%, 31/218 vs. 24.6%, 29/118), which was significantly different (P=0.018). Among them, infection occurred in 19 (8.7%) cases and 21 (17.8%) cases with significant difference between the two groups (P=0.014). The average time of follow-up was (34.5±1.2) months and (27.9±1.5) months in CME and traditional group, and the five-year survival rate was 85.6% and 78.0% with significant difference(P=0.043). Moreover, 102 cases underwent laparoscopic-assisted CME and 116 cases underwent open CME in CME group. The 5-year survival rate was 89.8% and 82.2% in laparoscopic and open group with significant difference (P=0.048).

CONCLUSIONCompared with traditional radical resection, CME radical resection for right hemicolon cancer can harvest more lymph nodes, decrease operative blood loss, lower the riskof postoperative complication, shorten the postoperative hospital stay, and increase the 5-year survival rate. Furthermore, laparoscopic-assisted CME has more advantages.

Adult ; Blood Loss, Surgical ; Colonic Neoplasms ; surgery ; Digestive System Surgical Procedures ; Female ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Male ; Mesocolon ; surgery ; Middle Aged ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate ; Treatment Outcome