Objective:To explore the clinical effect of laparoscopic high ligation of inguinal hernia sac in children with veress needle and semi-rigid biopsy forceps.Methods:121 cases of indirect hernia of groin admitted in Rugao People's Hospital from June 2018 to November 2019 were analyzed retrospectively. According to the operation methods, 121 cases were divided into laparoscopic group ( n=76, laparoscopic high ligation of hernia sac with pneumoperitoneum needle and semi rigid biopsy forceps) and traditional operation group ( n=45, high ligation of traditional inguinal incision hernia sac). The operation time, intraoperative blood loss, incision length, postoperative self activity time and postoperative hospital stay were compared between the two groups; the patients were followed up for 3-21 months, and the proportion of postoperative complications and recurrence cases were compared between the two groups. Results:There was no significant difference in operative time between the two groups ( P=0.335), but the amount of bleeding [(3.8±0.7)ml vs (7.3±1.7)ml, P<0.05], the length of incision [(0.6±0.1)cm vs (1.8±1.2)cm, P<0.05], the time of recovery of self activity [(9.2±2.6)h vs (16.2±4.2)h, P<0.05] and the time of hospitalization [(1.3±0.6)d vs (3.4±1.3)d, P<0.05] in the laparoscopic group were all better than those in the traditional operation group; the proportion of complications and recurrence in the laparoscopic group during the follow-up period was less than that in the traditional operation group (χ 2=5.243, P=0.022). Conclusions:Laparoscopic high ligation of indirect hernia sac in children with veress needle and semi-rigid biopsy forceps has the advantages of small trauma, fast recovery and less postoperative complications, and the equipment is easy to obtain, which is convenient to carry out and promote in basic hospitals.

BACKGROUND:Various surface modification techniques have been used to improve the bioactivity of titaniumimplant in vivo. OBJECTIVE:To investigate the effects of enamel matrix proteins (EMPs) on the growth of apatite coatings on dual thermo-etching treated pure titanium. METHODS:EMPs were extracted from porcine tooth germs and then were identified. Dual thermo-etching was applied to treat titanium samples fol owing polished, and then immersed in a blank simulated body fluid supersaturated calcification solution (control group) or supersaturated calcification solution containing different concentrations of EMPs for 7 days. The morphology of samples was observed using scanning electron microscope, and element components and crystal structures of the apatite coatings were analyzed by energy dispersive spectrometer and X-ray diffraction. RESULTS AND METHODS:After double-etching, a pit-like rough surface was observed on the titanium plate. After 7-day mineralization, in the control group, no overt calcium-phosphate deposits were found on the titanium surface;however, in the experimental groups, there were calcium-phosphate deposits, whose quantity and morphology changed with increasing concentrations. Energy dispersive spectrometer showed that the main element components of the mineralized coating included calcium, phosphorus, oxygen and carbon, and the calcium-phosphate ratio ranged from 1.32 to 1.41. The apatite coatings were proved to be carbonate hydroxyapatite by X-ray diffraction. To conclude, EMPs promote apatited deposition on pure titanium surfaces in a concentration-dependent manner.

Objective To analyse the changes of T lymphocytes and its subset in patients with scar hypertrophy. Methods In 6 keloid, 14 hypertrophic scar patients and 10 normal control, peripheral blood T lymphocytes (PBTL) and its subset were analysed with flow cytometry (FCM). Lymphocytic proliferation responsed to Con A stimulation in vitro lymphocytic culture system were performed and lymphocytic proliferation activity were assayed by the measurement of 3H TdR incorporation. Results The percent of CD3 +,CD4 +,CD8 + and ratio of CD4 +/CD8 + in PBTL of keloid patients were 78.6 %, 49.7 %, 23.5 % and 2.4, and in hypertrophic scar patients group were 68.9 %, 47.6 %, 26.6 % and 2.2, in normal control group were 69.2 %, 37.2 %, 30.9 % and 1.9, respectively. Lymphocytic proliferation activity expressed as proliferation stimulation index were 17.4,15.9 and 8.7 respectively in keloid, hypertrophic scar and normal group. The level of CD4 +?CD4 +/CD8 + and lymphocytic proliferation stimulative index were all significantly higher in both keloid and hypertrophic scar patients than that in normal control. Conclusion Aberrant immunologic function may play an important role in the pathogenesis of scar.

Objective To observe the therapeutic effect of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets for chronic functional constipation. Methods Sixty patients with chronic functional constipation were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was treated with Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets orally, and the control group was treated with oral administration of Prucalopride Succinate Tablets alone. The therapeutic effects on traditional Chinese medicine (TCM) symptoms and constipation, and the follow-up therapeutic effect of the two groups were evaluated after treatment. During the three months after the completion of treatment course, the recurrence of constipation was monitored. Results (1) The cure rate of the treatment group was 90.0％ and that of the control group was 60.0％, indicating that the therapeutic effect on TCM symptoms in the treatment group was stronger than that of the control group(P < 0.05).(2) In respect of the relief of constipation, the markedly effective rate was 93.3％ in the treatment group and was 50.0％ in the control group, and the overall effective rate was 100.0％ in the treatment group and was 73.3％ in the control group, the difference being significant between the two groups(P<0.05 or P<0.01).(3) During the treatment, the percentage of patients with weekly completely spontaneous defecation frequency ≥3 was 86.7％ in the treatment group, and was 53.3％ in the control group, the difference being significant (P < 0.05). (4) The results of 3-month follow-up after the completion of treatment course showed that one case from the treatment group had the recurrence of constipation, and the recurred cases from the control group were 6, the difference being significant (P < 0.05). Conclusion Oral use of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets exerts certain therapeutic effect for chronic functional constipation, which is effective both on relieving constipation symptoms and on reducing recurrence rate.

Objective To analyze the expression of dystrophin associated glycoprotein complex (DGC) in Duchnne muscular dystrophy (DMD) in different age groups. Methods The confirmed 24 DMD patients were divided into 3 groups according to their chronological age (children whose age between 1 to 3 were assigned to early childhood group; children whose age between 3 to 6 were assigned to preschool group; children whose age between 6 to 13 were assigned to school-age group). Several proteins from sarcolemmal muscle membrane were analyzed by immunohistocbemistry. Results The primary loss of dystrophin may lead to a secondary or completely deficiency of α-SG, β-SG, γ-SG,δ-SG, β-DG and dysferlin from sarcolemmal muscle membrane in different age groups. The expression of nNOS is completely deficient in the 3 groups, while the expression of caveolin-3 increased. Conclusions The expression of dystrophin related DGC proteins from DMD patients in different age groups showed diversed degrees of deficiency or complete deficiency. The deficiency of these proteins may occur during the embryonic period, while the increased expression of eaveolin-3 may have a relation with the regeneration of skeletal muscle fibers.

Objective To investigate the effects of Zuogui Jiangtang Yishen decoction (ZGJTYS) on the expression of nephrin and podocin in podocyte of MKR mice with diabetic nephropathy (DN), and explore its mechanism. Methods Forty MKR mice (8 weeks old) were randomly divided into four groups as follows:negative control group (group A), DN model group (group B), ZGJTYS group (group C) and positive control group (group D, Gliquidone and benazepri). All mice from group B, C and D were received high-fat diet feed and unilateral nephrectomy. Four weeks after operation, all mice were received drug intervention, and four weeks later, all mice were put to death. The levels of UmAlb were observed by ELISA, the serum BUN and Cr by biochemical, and the FBG by electrochemical detection method. The nephrin and podocin mRNA expression were measured by RT-PCR and the protein expression by western blotting. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results As compared with group A, FBG, BUN, SCr and urine UmAlb in the mice of group B increased significantly (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly decreased (P<0.01). After intervention of drugs, all biochemical indicators above in the mice of group C and D significantly decreased (P<0.01), the expression level of nephrin and podocin mRNA and protein were markedly increased (P<0.01, P<0.05), compared with group B. The renal pathological lesions of group C and D were significantly improved compared with group B. Conclusion ZGJTYS decoction exerts reno-protective effect via reinstating nephrin and podocin expression to repair the damaged podocyte.

Objective: To evaluate the effect of penehyclidine hydrochloride (PHC) on Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway in non-ventilated lung injury in the patients undergoing radical operation for lung cancer. Methods: A total of 100 patients, aged 40-64 yr, with body mass index 18-27 kg/m², of American Society of Anesthesiology physical status Ⅱ or Ⅲ, undergoing radical operation for lung cancer, were divided into 2 groups (n=50 each) according to the random number table method: control group (group C) and PHC group.PHC 0.01 mg/kg was intravenously injected at 10 min before anesthesia induction in group PHC, while the equal volume of normal saline was given instead in group C. The peripheral tissues of the removed lung tissues were obtained for determination of wet/dry weight ratio (W/D ratio). The pathological changes and ultrastructure of lung tissues were observed under light microscope, and lung injury was assessed and scored.The expression of TLR4 and NF-κB protein and mRNA was detected by Western blot and real-time polymerase chain reaction, respectively.Before administration (T₀), at the onset of one-lung ventilation (T₁), at 60 min of one-lung ventilation (T₂), immediately after the end of one-lung ventilation (T₃), at the end of operation (T₄) and at 24 h after operation (T₅), blood samples were collected from the internal jugular vein for determination of serum tumor necrosis factor-alpha, interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay. Results: Compared with group C, the W/D ratio and lung injury scores were significantly decreased, the expression of TLR4 and NF-κВ protein and mRNA was down-regulated, and the concentrations of tumor necrosis factor-alpha, IL-6 and IL-8 were decreased at T₂-T₅ in group PHC (P<0.05). The pathological changes and damage to ultrastructure of lung tissues were significantly attenuated in group PHC as compared with group C. Conclusion The mechanism by which PHC attenuates non-ventilated lung injury is related to blocking TLR4/NF-κВ signaling pathway and reducing inflammatory responses in the patients undergoing radical operation for lung cancer.

Objective:To evaluate the role of histone deacetylase 6 (HDAC6) in spinal dorsal horn in dexmedetomidine-induced reduction of neuropathic pain (NP) in rats.Methods:Forty clean-grade healthy male Sprague-Dawley rats, aged 7-9 weeks, weighing 190-240 g, were divided into 5 groups ( n=8 each) using a random number table method: control group (group C), sham operation group (group SH), group NP, dexmedetomidine group (group D), and specific HDAC6 inhibitor ACY-1215 plus dexmedetomidine group (group AD). The animals were commonly fed without any treatment in group C. The sciatic nerve was only isolated but not ligated in group SH.The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg.NP was induced by chronic constrictive injury (CCI). The right sciatic nerve was exposed, and 4 loose ligatures were placed on the sciatic nerve at 1-mm intervals with 4-0 silk thread in NP and D groups.In group D, dexmedetomidine 40 μg/kg was intraperitoneally injected once a day starting from the end of operation until the animals were sacrificed.In group AD, ACY-1215 25 mg/kg was intraperitoneally injected every day immediately before CCI, and dexmedetomidine 40 μg/kg was intraperitoneally injected daily after CCI until 15 days after CCI.The equal volume of solvent was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI (baseline, T 0) and 3, 6, 9, 12 and 15 days after CCI (T 1-5). The rats were then sacrificed, and the dorsal horn tissues of L 4-6 spinal cord were obtained for determination of the expression of myeloid differentiation factor 88 (MyD88) and nuclear factor kappa B (NF-κB) p65 by Western blot. Results:Compared with group C and group SH, the MWT was significantly decreased, and the TWL was shortened at T 1-5, and the expression of MyD88 and NF-κB p65 in the spinal dorsal horn was up-regulated in NP, D and AD groups ( P<0.05). Compared with group NP, the MWT was significantly increased, and the TWL was prolonged at T 1-5, the expression of MyD88 and NF-κB p65 in the spinal dorsal horn was down-regulated in group D ( P<0.05), and no significant change was found in the parameters mentioned above in group AD ( P>0.05). Compared with group D, MWT was significantly decreased, and TWL was shortened at T 1-5, and the expression of MyD88 and NF-κB p65 was up-regulated in the dorsal horn of the spinal cord in group AD ( P<0.05). Conclusion:HDAC6 in spinal dorsal horn is involved in dexmedetomidine-induced reduction of NP in rats, which is related to inhibiting MyD88/NF-κB signaling pathway.

Objective:To study the effect of magnetic nursing concept on improving nurses' nursing ability of extracorporeal membrane oxygenation (ECMO).Methods:In the study, 33 nurses of emergency intensive care unit of The First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were selected as the research objects. From January 2019 to December 2019, the Department carried out routine nursing management, and from January 2020 to December 2020, the Department implemented the management mode of magnetic nursing concept. The mastery of nursing knowledge of ECMO was analyzed by using scale, and the critical thinking ability and self-study ability of the nurses were compared before and after intervention. SPSS 22.0 was used to perform t test on the data. Results:After the intervention, nurses' mastery of respiratory system nursing, circulatory system nursing, fluid balance nursing, skin nursing, digestive system nursing, bleeding, anticoagulant problem nursing, hospital infection prevention and control, and pipeline nursing related knowledge of ECMO patients was significantly better than that before the intervention ( P<0.05). After the intervention, nurses' truth-seeking, open thinking, systematic ability, analytic ability, thinking self-confidence, thirst for knowledge, cognitive maturity and total scale scores were significantly higher than those before the intervention ( P<0.05). After the intervention, nurses' self motivation belief, task analysis, self-monitoring and regulation, self-evaluation and total score were significantly higher than those before the intervention ( P<0.05). Conclusion:The nursing management mode of magnetic nursing concept is of value in improving nurses' autonomous learning ability and critical thinking ability.

Objective:To evaluate the clinical effect of Huanglian-Wendan Decoction combined with Estazolam tablets in the treatment of post-stroke sleep disorders (PSSD) with syndrome of internal disturbance of phlegm-heat. Methods:A total of 96 patients with PSSD who met the inclusion criteria in the People's Hospital of Shenzhen Luohu District from September 2016 to June 2018 were randomly divided into the control group (47 cases) and the study group (49 cases) by random number table method. The control group took Estazolam tablets based on routine treatment, and the intervention group took Huanglian-Wendan Decoction based on the control group. Both groups were treated for 2 weeks. The TCM syndromes were recorded and scored before and after the treatment. The anxiety symptoms were assessed by Hamilton Anxiety Scale (HAMA) and the depression symptoms were assessed by Hamilton Depression Scale (HAMD) respectively. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). The level of brain-derived neurotrophic factor (BDNF) was detected by ELISA, the level of 5-hydroxytryp-tamine (5-HT) was detected by high performance liquid-phase electrochemical detector. The adverse reactions were recorded and clinical efficacy was evaluated. Results:The total clinical effective rate of the intervention group was 91.8% (45/49), and 76.6% (36/47) in the control group. There was significant difference between the two groups ( χ2=4.227, P=0.040). After the treatment, the scores of HAMA, HAMD and PSQI in the intervention group were significantly lower than that of the control group ( t value were 4.081, 4.869 and 3.900, respectively, all Ps<0.001). The levels of serum BDNF (42.36 ± 6.78 ng/ml vs. 33.98 ± 6.41 ng/ml, t=6.217), 5-HT (127.21 ± 12.39 ng/ml vs. 101.46 ± 11.70 ng/ml, t=10.460) were significantly higher than that of the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 14.9% (7/47) in the control group and 8.2% (4/49) in the intervention group, and there was no significant difference between the two groups ( χ2=1.071, P=0.301). Conclusions:Huanglian-Wendan Decoction combined with Estazolam tablets can improve the clinical symptoms, relieve anxiety and depression of PSSD patients with syndrome of internal disturbance of phlegm-heat, and improve sleep quality and clinical efficacy.