Objective To evaluate the preoperative T staging value of rectal carcinoma by using double contrast-enhanced ultrasonography (DCUS).Methods 71 patients with rectal carcinoma were examined by ultrasound after infusing contrast agent and bolus injection of SonoVue preoperatively.The border,shape and perfusion patterns of the tumor were observed.After surgery,the T staging made by DCUS and perfused contrast-enhanced ultrasonography (PCUS) was compared with final pathologic results respectively.Results The accuracy of PCUS and DCUS in determining the T stage of rectal carcinoma were 71.8％(T1 72.7％％,T250.0％,T374.4％,T476.9％) and 85.9％(T190.9％,T275.0％,T387.1％,T484.6％) respectively.The difference between these two methods was statistically significant (P ＜0.05).Conclusions DCUS is a new valuable method for T staging of rectal carcinoma with its high accuracy preoperatively.

Objective To explore nursing management in the prevention of hospital infection of elderly patients.Methods 922 hospitalized patients(60-91 year old)were retrospectively analyzed in our hospital from January 2009～December 2010.Nurses were educated about various factors influencing hospital infection.Results Among elderly hospital infection patients,respiratory tract infections,urinary trot infections were major factors.Traumatic operation,and body resistance drops,unreasonable application of antimierobial drugs,medical persons lacking cross-infection consciousness,etc.are also infection factors.Conclusions It was important to pay special attention to and strengthen nursing management and standardize the nursing procedures for the prevention of elderly patients.

To explore the growth and development and analyze the quality of the parthenocarpy fruit induced by exogenous hormones of Siraitia grosvenorii. the horizontal and vertical diameter, volume of the fruit were respectively measured by morphological and the content of endogenous hormones were determined by ELISA. The size and seed and content of mogrosides of mature fruit were determined. The results showed that the fruit of parthenocarpy was seedless and its growth and development is similar to the diploid fruit by hand pollination and triploid fruit by hand pollination or hormones. But the absolute value of horizontal and vertical diameter, volume of parthenocarpy fruit was less than those of fruit by hand pollination, while triploid was opposite. The content of IAA, ABA and ratio of ABA/GA was obviously wavy. At 0-30 d the content of IAA and ABA of parthenocarpy fruit first reduced then increased, content of IAA and GA parthenocarpy fruit was higher than that of fruit by hand pollination. Mogrosides of parthenocarpy fruit was close to pollination fruit. Hormones can induce S. grosvenorii parthenocarpy to get seedless fruit and the fruit shape and size and quality is close to normal diploid fruit by hand pollination and better than triploid fruit by hormone or hand pollination.
Cucurbitaceae ; chemistry ; drug effects ; genetics ; growth & development ; Diploidy ; Fruit ; chemistry ; genetics ; growth & development ; Plant Growth Regulators ; pharmacology

Siraitia grosvenorii is a traditional Chinese medicine also as edible food. This study selected six candidate reference genes by real-time quantitative PCR, the expression stability of the candidate reference genes in the different samples was analyzed by using the software and methods of geNorm, NormFinder, BestKeeper, Delta CT method and RefFinder, reference genes for S. grosvenorii were selected for the first time. The results showed that 18SrRNA expressed most stable in all samples, was the best reference gene in the genetic analysis. The study has a guiding role for the analysis of gene expression using qRT-PCR methods, providing a suitable reference genes to ensure the results in the study on differential expressed gene in synthesis and biological pathways, also other genes of S. grosvenorii.
Cucurbitaceae ; genetics ; RNA, Ribosomal, 18S ; genetics ; Real-Time Polymerase Chain Reaction ; methods ; Reference Standards

Objective:To construct and validate a theoretical model of residents′ willingness to participate in tiered medical care based on harmonious management theory, providing reference for promoting the tiered medical care system and aiding governmental decision-making.Methods:Based on the harmonious management theory and literature review, a model capturing residents′ propensity to engage in tiered medical care was formulated. Using convenience sampling method, a questionnaire survey was conducted on 2 067 residents from 24 communities in Zhejiang province from April to May 2022. Descriptive statistical analysis was conducted on the survey results, and multilevel linear regression and structural equation modeling were used to analyze the driving mechanism of residents′ willingness to participate in tiered medical care.Results:The willingness rate of residents to participate in tiered medical care was 69.7%, which was at an average level. Regression insights highlighted the positive influence of policy support perception ( β=0.170, P<0.01), awareness of management mechanisms ( β=0.093, P<0.01), cognitive attitudes ( β=0.102, P<0.01), and trust levels ( β=0.244, P<0.01) on residents′ participation willingness. In contrast, resource allocation perceptions lacked a significant effect ( β=0.065, P>0.05). The structural equation model revealed that cognitive attitudes played a mediating role in the " policy system perception → participation willingness" and " management mechanism perception → participation willingness" pathways, with effect sizes of 0.030 and 0.039, respectively. Trust levels also mediated these paths, with effect sizes of 0.039 and 0.045, and entirely mediated the " resource allocation perception → participation willingness" path, registering an effect size of 0.053. Conclusions:The harmonious management theory can be used to explain the formation mechanism of residents′ willingness to participate in tiered medical care. The government and medical institutions urgently need to further improve residents′ awareness of tiered medical care, focus on enhancing residents′ trust, and further improve policies and management measures such as financial investment, medical insurance reimbursement, and referral systems.

OBJECTIVETo explore a better approach to resect the advanced oropharyngeal carcinoma.

METHODSFrom 1995 to 2005, 17 patients underwent mandibular swing procedure for excision of advanced oropharyngeal carcinoma including: 13 tonsillar cancers, 2 soft palate carcinomas and 2 lingual root cancers. Surgical procedure was selected according to the lesion. All tumors were resected through the mandibular swing approach or its combined approaches. Immediate reconstruction of the surgical defect was done using tongue flap, pectoralis major myocutaneous flap, sternohyoid myofascial flap, temporalis myofascial flap and forehead flap, respectively. After surgical resection of the tumors, all patients received postoperative radiotherapy.

RESULTSAll patients' advanced oropharyngeal carcinoma were successfully resected as planned through the mandibular swing procedure or its combined procedures without severe complications. Functions of deglutition, respiration and speech were well restored. The 3- and 5-year survival rate was 54. 5% and 40%, respectively.

CONCLUSIONThe mandibular swing procedure and its combined approach is safe and effective in the surgical resection of the advanced oropharyngeal carcinoma, which can provide a good exposure for the oropharynx, supraglottic region, hypopharynx, the parapharyngeal space and the base of the skull.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Male ; Mandible ; radiation effects ; surgery ; Middle Aged ; Neoplasm Staging ; Oropharyngeal Neoplasms ; pathology ; radiotherapy ; surgery ; Postoperative Period ; Radiotherapy, Adjuvant ; Survival Analysis ; Tonsillar Neoplasms ; pathology ; radiotherapy ; surgery

OBJECTIVETo compare differences of angiogenesis among collagen- chitosan, collagen-sulfonated carboxymethyl chitosan porous scaffolds and acellular dermal matrix after these three different scaffolds with silicone membrane were transplanted on the wounds of full thickness burn, and the wound repair of different scaffolds with epidermis grafting on.

METHODSAngiogenesis in different dermal scaffolds, the wound surface and epidermis survival were observed in 1, 2, and 3 weeks after the three different scaffolds were respectively transplanted on wounds of full thickness burn with debridement in 6 Bama miniature pigs (total 18 pigs in 3 groups). At the same time, CD34 positive signals (neo-forming microvessels) were detected by immunohistochemical staining. The wounds without any scaffold transplantation were studied as the control.

RESULTSAngiogenesis had been fundamentally finished in 2 weeks after implantation of collagen- sulfonated carboxymethyl chitosan porous scaffold. And fundamental angiogenesis in collagen- chitosan porous scaffolds and acellular dermal matrix needed at least 3 weeks. Neo-forming micro-vessels perpendicular to wound beds with these three different scaffolds were more than those in the control wounds without scaffold. CD34 positive signals (neo-forming micro-vessels) were significantly higher in wounds at the second week than those in wounds at the first week. And those in wounds at the third week were significantly higher than those in wounds at the second week in all wounds with different scaffold transplantations and the control wounds. CD34 positive signals in the group of sulfonated carboxymethyl chitosan porous scaffold on the 1st, 2nd and 3rd week after the scaffold transplantation were significantly higher than those corresponding signals in the other three groups. Epidermis on the sulfonated carboxymethyl chitosan porous scaffold which had been transplanted on burn wound for 1 week could survive perfectly, however, epidermis on the collagen- chitosan porous scaffold or acellular dermal matrix could not survive until these two scaffolds had been transplanted on the burn wounds for at least 2 weeks.

CONCLUSIONSThese three different scaffolds could repair the full thickness skin defects caused by burn, and angiogenesis of sulfonated carboxymethyl chitosan porous scaffold is the best.

Animals ; Burns ; surgery ; Chitosan ; analogs & derivatives ; Collagen ; Disease Models, Animal ; Female ; Silicones ; Skin Transplantation ; Skin, Artificial ; Swine ; Swine, Miniature ; Tissue Scaffolds

OBJECTIVETo investigate the roles and differences of angiogenesis of different dermal scaffolds on wound contraction and apoptosis during full-thickness burn wound repair.

METHODSWounds were observed at different time after the collagen-sulfonated carboxymethyl chitosan porous scaffold or collagen-chitosan porous scaffold or acellular dermal matrix were respectively transplanted on wounds of full thickness burn with debridement in Bama miniature pigs. At the same time, vessels and myo-fibroblasts expressing α-smooth muscle action(α-SMA) and apoptosis in wounds of different time were detected in situ by immunohistochemical staining, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling. The burn wounds without any scaffold transplantation were studied as the control.

RESULTSWounds with different scaffolds transplantation were different from granulation wounds. Vessels expressing α-SMA had been increasing continuously in the wounds from 1 to 3 weeks after different scaffolds transplantation and decreased in wounds after epidermis had been grafted for 2 weeks on surface of the scaffolds transplanted on wounds for 2 weeks. Vessels expressing α-SMA were the most in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the least in the control wounds without dermal scaffold at different time. Myo-fibroblasts expressing α-SMA was the least in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the peak of expressions was on the 2nd week, however, the peak in the wounds with the other two scaffolds transplantation and in the control wound without dermal scaffold was on the 3rd week. Myo-fibroblasts expressing α-SMA was the most in the control wounds. Apoptosis had been increasing continuously in the transplantation wounds from 2 to 4 weeks after different scaffolds transplantation, however, apoptosis had begun to increase continuously from 3 to 4 weeks in the control wounds. Apoptosis was the most in the wounds with collagen-sulfonated carboxymethyl chitosan porous scaffold transplantation and the least in the control wounds without dermal scaffold from 3 to 4 weeks.

CONCLUSIONSulfonated carboxymethyl chitosan can promote migration of reparative cells and angiogenesis, and it can repair full-thickness burn wound fast and well.

Animals ; Apoptosis ; Burns ; pathology ; surgery ; Chitosan ; analogs & derivatives ; pharmacology ; Collagen ; Disease Models, Animal ; Female ; Skin Transplantation ; Skin, Artificial ; Swine ; Tissue Scaffolds

OBJECTIVETo investigate the relationship between endothelial progenitors cells (EPCs) and endothelium-dependent vasodilation in patients with unstable angina pectoris.

METHODSThirty patients with unstable angina pectoris (UAP) and thirty control subjects were recruited. Flow-mediated dilation (FMD) in the brachial artery was evaluated by using ultrasound Doppler flow method. The number of circulating EPCs was analyzed by flow cytometry analysis. Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. CD34 antigen of adherent cells was identified by immunohistochemical assay. EPCs were characterized as adherent cells double positive for FITC-UEA-I binding and DiI-acLDL uptake by direct fluorescent staining under inverted fluorescent microscope.

RESULTSFMD was significantly impaired in the UAP group compared with the control group (5.93% +/- 2.67% vs 11.1% +/- 4.36%, P < 0.05). There was no significant difference in NMD between two groups (13.60% +/- 5.03% vs 14.18% +/- 4.50%, P > 0.05). The number of CD34(+) cells significantly increased in the UAP group compared with the control group (0.13% +/- 0.05% vs 0.09% +/- 0.04%, P < 0.05). There was a negative association between impaired FMD and increased CD34(+) cell (r = -0.385, P < 0.05). A positive antigen of CD34 of adhesion cells and double positive adhesion cells were found.

CONCLUSIONThis study shows that the levels of peripheral CD34(+) cells in patients with UAP increase with an impaired endothelial function. The increase in EPCs may be an important compensatory response to acute coronary ischemia and impaired endothelium in patients with UAP.

Aged ; Angina, Unstable ; blood ; metabolism ; Antigens, CD34 ; Case-Control Studies ; Endothelial Cells ; cytology ; Endothelium, Vascular ; cytology ; Female ; Humans ; Male ; Middle Aged ; Stem Cells ; cytology

Objective To develop and validate the radiomics nomogram on the discrimination of lung invasive adenocarcinoma from'non-invasive'lesion manifesting as ground glass nodule(GGN)and compare it with morphological features and quantitative imaging. Methods One hundred and sixty pathologically confirmed lung adenocarcinomas from November 2011 to December 2014 were included as primary cohort. Seventy-six lung adenocarcinomas from November 2014 to December 2015 were set as an independent validation cohort. Lasso regression analysis was used for feature selection and radiomics signature building. Radiomics score was calculated by the linear fusion of selected features. Multivariable logistic regression analysis was performed to develop models. The prediction performances were evaluated with ROC analysis and AUC,and the different prediction performance between different models and mean CT value were compared with Delong test. The generalization ability was evaluated with the leave-one-out cross-validation method. The performance of the nomogram was evaluated in terms of its calibration. The Hosmer-Lemeshow test was used to evaluate the significance between the predictive and observe values.Results Four hundred and eighty-five 3D features were extracted and reduced to 2 features as the most important discriminators to build the radiomics signatures. The individualized prediction model was developed with age, radiomics signature, spiculation and pleural indentation, which had the best discrimination performance(AUC=0.934)in comparison with other models and mean CT value(P<0.05)and showed better performance compared with the clinical model(AUC=0.743,P<0.001).The radiomics-based nomogram demonstrated good calibration in the primary and validation cohort, and showed improved differential diagnosis performance with an AUC of 0.956 in the independent validation cohort. Conclusion Individualized prediction model incorporating with age, radiomics signature, spiculation and pleural indentation, presenting with radiomics nomogram, could differentiate IAC from'non-invasive'lesion manifesting as GGN with the best performance in comparison with morphological features and quantitative imaging.