Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Cholecystectomy ; Gallbladder Neoplasms ; pathology ; surgery ; Humans ; Male

Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.

This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age.We searched for randomized controlled trials (RCTs) in electronic databases,including MEDLINE,EMBASE and CENTRAL (from inception to January 2018);in addition,we hand-searched the reference lists of included studies and similar reviews.We included RCTs comparing AH versus no treatment (control).The meta-analysis was performed by RevMan 5.3 software.The search retrieved 943 records and 8 RCTs were included,comprising 870 cycles (n=440 for AH,and n=430 for control).There was no significant difference in the rates of live birth (RR 0.88,95％ CI 0.65 to 1.18,3 RCTs,n=427,I2=0％),clinical pregnancy (RR 1.00,95％ CI 0.83 to 1.19,8 RCTs,n=870,I2=22％),implantation (RR 1.07,95％ CI 0.83 to 1.39,4 RCTs,n=1359,I2=0％),miscarriage (RR 1.13,95％ CI 0.66 to 1.94,2 RCTs,n=116,I2=0％) and multiple pregnancy (RR 0.89,95％ CI 0.31 to 2.52,1 RCT,n=97,I2=not applicable) between the treatment group and control group.No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses.Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.

In this study, the buffering capacity of amphiphilic pH-sensitivity copolymer poly(2-ethyl-2-oxazoline)-cholesteryl methyl carbonate (PEOZ-CHMC) was evaluated. The ammonium sulfate gradient method was used to prepare doxorubicin hydrochloride (DOX x HCl)-loaded liposomes (DOX-L), and then the post-insertion method was used to prepare PEOZ-CHMC and polyethylene glycol-distearoyl phosphatidyl ethanolamine (PEG-DSPE) modified DOX x HCl-loaded liposomes (PEOZ-DOX-L and PEG-DOX-L). The physico-chemical properties, in vitro drugs release behavior, cellular toxicity and intracellular delivery of liposomes were evaluated, separately. The results showed that PEOZ-CHMC has a satisfactory buffering capacity. The sephadex G-50 column centrifugation method and dynamic light scattering were used to determine the encapsulation efficiency (EE) and particle size of liposomes. The EE and particle size of DOX-L were (97.3 ± 1.4) % and 120 nm, respectively, and the addition of PEOZ-CHMC or PEG-DSPE had no influence on EE and particle size. The zeta potentials of three kinds of liposomes were negative. The release behavior of various DOX liposomes in vitro was investigated by dialysis method. In phosphate buffer solution (PBS) at pH 7.4, DOX x HCl was released from PEOZ-DOX-L in a sustained manner. While in PBS at pH 5.0, the release rate of DOX x HCl from PEOZ-DOX-L increased significantly, which suggested DOX x HCl was released from PEOZ-DOX-L in a pH-dependent manner. The intracellular delivery of liposomes was investigated by confocal laser scanning microscopy (CLSM). The CLSM images indicated that PEOZ-DOX-L showed efficient intracellular trafficking including endosomal escape and release DOX x HCl into nucleus, as well as the DOX-L and PEG-DOX-L had no this effect. The cytotoxicity of liposomes against MCF-7 cells was detected by using MTT assay. The results showed that antiproliferative effects of PEOZ-DOX-L enhanced with pH value decreased, whereas DOX-L and PEG-DOX-L did not have any significant difference in inhibitions at different pH conditions. Therefore, the problems of the inhibition of cellular uptake of liposomes and the failed endosomal escape of pH-sensitive liposomes by PEG chain can be overcome by the pH-sensitive liposomes constructed by PEOZ-CHMC.
Cell Nucleus ; Doxorubicin ; analogs & derivatives ; chemistry ; Endosomes ; Formates ; chemistry ; Humans ; Liposomes ; chemistry ; MCF-7 Cells ; Microscopy, Confocal ; Particle Size ; Phosphatidylethanolamines ; Polyamines ; chemistry ; Polyethylene Glycols ; chemistry

Obejective To explore the inhibition effects of erlotinib on invasion and metastasis in non -small cell lung cancer brain metastasis cell PC14/B.Methods MTT method was used to detect the viability of PC14/B cells 48 h after the cultivation with erlotinib of 0 ( control group), 1, 5 and 25 μmol· L -1(erlotinib ,test groups).The cell inva-sion was detected by tranaswell method.The phosphorylation of protein kinase B ( AKT ) and the expression of matrix metalloproteinase 2 ( MMP2 ) , MMP9 epithelial -mesenchymal transition ( EMT ) related proteins including E -cadhherin and Vimentin were detected by Western blot.Results Compared with control group (0.75 ±0.09), three dose test groups[(0.63 ±0.06), (0.52 ±0.04), (0.38 ±0.03)] inhibited the cell viability.Compared with control group , three dose test groups inhibited invasion, up -regulated the expression of E -cadherin, and down-regulated the expressions of MMP2, MMP9, Vimentin and the phosphorylation of AKT.Conclusion Erlotinib suppressed PC 14/B cell invasion and metastasis , which was related to the down -regulation of the expression of MMPs , and the inhibition on the generation of EMT and the phosphorylation of AKT.

The paper introduces the design and implementation of residents online medical examination report query system based on cloud platform,including the system architecture,process,data structure,security and necessary controls,etc.This system makes it able for the residents to check their medical examination reports and corresponding video pictures whenever and wherever possible on the Internet.

Objective:To evaluate the value of VueBox ? contrast-enhanced ultrasound (CEUS) quantitative analysis combined with ACR TI-RADS classification in the diagnosis of benign and malignant solid thyroid nodules. Methods:A total of 201 patients with thyroid solid nodules (201 nodules) who underwent surgery or puncture biopsy in the People′s Hospital of Guangxi Zhuang Autonomous Region were enrolled from October 2020 to February 2022. The preoperative conventional ultrasound and contrast-enhanced ultrasound images were retrospectively analyzed. According to the pathological results, they were divided into the malignant group and benign group. The differences of the quantitative parameters of CEUS between the two groups were analyzed, including peak enhancement (PE), wash-in and wash-out area under the curve (WiWoAUC), wash-in perfusion index (WiPI). ΔPE, ΔWiWoAUC, ΔWiPI were obtained by calculating the parameter difference between the surrounding normal glands and nodules. ROC curve was used to analyze the value of different quantitative parameters in the differential diagnosis of benign and malignant solid thyroid nodules. The CEUS quantitative parameters with best diagnostic performance was selected and combined with ACR TI-RADS classification system to evaluate the diagnostic efficiency of the single diagnostic approaches and the combined approach.Results:The quantitative parameters of PE, WiWoAUC, WiPI, ΔPE, ΔWiWoAUC, ΔWiPI were significantly different between benign group and malignant group (all P<0.001). ΔPE had the highest diagnostic value among all the quantitative parameters (the area under the ROC curve was 0.802), and the cut-off value was 0.21.ΔPE combined with ACR TI-RADS classification showed the best efficiency in diagnosis of benign and malignant thyroid nodules, with an area under the curve of 0.898, and the sensitivity, specificity, positive predictive value and negative predictive value of 73.39%, 93.48%, 93.02% and 74.78%, respectively. Conclusions:Quantitative parameters of CEUS by using VueBox ? software is valuable for the differential diagnosis of benign and malignant solid thyroid nodules, and its combination with ACR TI-RADS classification can improve the diagnosis accuracy.

BACKGROUNDFalls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics.

METHODSConsecutive retrospective cross-sectional design spanned July 2006 to December 2008.

PATIENT GROUPInformation on all aged care inpatients who suffered from 1 or more falls was extracted from Incident Information Management System (IIMS). Further details about the particular admission(s) were obtained from patients' medical records, e.g., patients' characteristics and circumstances surrounding the falls. Randomly selected aged care patients who did not suffer from a fall and who were discharged from the hospital in the same period served control group. Characteristics among patients with single fall and recurrent falls, as well as non-fallers were compared.

RESULTSOf the 438 falls evaluated, 71.9% occurred in patients' room and 18.9% in patients' bathroom/toilet. The common activities were moving/transferring and taking shower/toileting, respectively, 70.3%, 12.1% while occurring falls; and time of falls had a high peak during 9:00-11:00 a.m. Many were unassisted while falling. The common contributing factors for fall were intrinsic factors. Patients with recurrent falls were more likely to have lower Mini-Mental State Examination (MMSE) score. Logistic regression analysis showed length of stay longer than five weeks, dementia and stroke were independent risk factors for recurrent falls; and living in hostel/nursing home preadmission, needing assistance with mobility, cognitive impairment, stroke, incontinence and arthritis/osteoporosis were independent risk factors for fall.

CONCLUSIONSIn an aged care ward, falls are independently associated with recurrent factors. Cognitive impairment/dementia was a strong risk factor for falls, and main causes leading to fall were intrinsic factors. For patients with cognitive impairment/dementia and behavioral disorder providing special and effective interventions is of paramount importance for reducing the incidence of fall in an aged care ward in hospital settings.

Accidental Falls ; statistics & numerical data ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Male ; Nursing Homes ; statistics & numerical data ; Retrospective Studies ; Risk Factors

Objective To study the expression of CD269 and CD317 antigens in bone marrow cells of patients with multiple myeloma (MM),analyze its correlation with the laboratory indexes reflecting the progression of MM and evaluate its value in clinical diagnosis and treatment.Methods 63 newly diagnosed MM patients were selected as the study group by a casecontrol study.The expression rate of CD269 and CD317 in bone marrow blood of 35 patients with iron deficiency anemia and other antigens in bone marrow blood of 63 patients with MM were detected by flow cytometry.The levels of serum hemoglo bin (Hb),serumβ2-MG(β2-MG) and lactatedehydrogenase (LDH) in patients with MM were dctectcd,and the levels of CD269 and CD317 were analyzed statistically.Results The positive rates of CD269 in the study group and control group were (86.6±2.35)％ vs (4.33±l.69)％,rcspectivcly (t =4.256,P＜0.05)).The positive rate of CD317 was (71.42+ 0.62)％ vs (8.32+ 3.89)％,the difference was statistically significant (t=3.102,P＜0.05).In other expression,the expression level of CD269 and CD317 in CD56 positive group was significantly higher than that of negative group (t=4.032,P＜0.05),while the expression of CD117 the level of positive group was significantly lower than that of the negative group (t 2.832,P＜0.05),CD19,CD20 expression was not statistically significant difference between the two groups (P＞ 0.05).The levels of CD269 and CD317 in patients with MM were positively correlated with the level of CD56 expression (r =0.392,P＜0.05),and negatively correlated with the level of CD117 expression (r=-0.210,P＜0.05).The levels of CD269 and CD317 in patients with MM were significantly lower than those in the negative group (t=3.012,P＜0.05) and the levels of serum LDH in the positive group were lower than those in the negative group (t=2.024,P＜0.05).There was a negative correlation between Hb content (r=-0.212,P＜0.05) and negatively correlated with serum β2-MG (r=-0.312,P＜0.05).Conclusion The high expression of CD269 and CD317 in bone marrow cells in MM patients is related to the increase of CD56 and decrease of CD117 in patients with MM.

Objective:To explore the effect of the NNN-link nursing model combined with International Dysphagia Diet Standardisation Initiative (IDDSI) graded diet management in patients with post-stroke dysphagia.Methods:From May 2021 to May 2023, convenience sampling was used to select 160 post-stroke dysphagia patients admitted to the Second Affiliated Hospital of Wenzhou Medical University. Study subjects were divided into a control group and an observation group using the computer random number table method, with 80 cases in each group. The control group received routine nursing in Department of Neurology, while the observation group was treated with NNN-link nursing model combined with IDDSI graded diet management on this basis. This study compared the Standardized Swallowing Assessment (SSA) and Functional Oral Intake Scale (FOIS) scores of two groups of patients who underwent intervention for 1 day, 7 days and 14 days, and compared the Mini-Nutritional Assessment (MNA), Swallowing Nursing Outcome Assessment, Swallowing-Quality of Life (SWAL-QOL) score, clinical efficacy, and incidence of stroke associated pneumonia (SAP) between two groups before and after intervention.Results:In the end, 79 cases in the observation group and 78 cases in the control group completed the study. After 7 days and 14 days of intervention, the SSA score of the observation group was less than that of the control group, the FOIS score was more than that of the control group, and the nursing compliance was higher than that of the control group, the MNA, nursing outcomes, and SWAL-QOL scores were more than those of the control group, and the total effective rate was higher than that of the control group, the incidence of SAP was lower than that of the control group, and the above differences were statistically significant ( P<0.05) . Conclusions:The combination of NNN-link nursing model and IDDSI graded diet management can improve the swallowing function of post-stroke dysphagia patients, increase clinical efficacy and quality of life, and reduce the incidence of SAP.