Genetic Therapy ; Humans ; Liver Neoplasms

Objective To investigate the current working status and explore the relationship among job stress, job burnout and organizational commitment in ICU nurses. Methods By using cluster random sampling method, 233 nurses from 5 general hospitals were selected to accept investigation by Commitment Questionnaire and Nurses' general situation questionnaire. Results The job stress and job burnout were both significant negatively correlated with organizational commitment (r=-0.33, P<0.01;r=-0.22, P < 0.01).The management issues and interpersonal relationships and decreased personal accomplishment both had significant impact on affective commitment and continuance commitment of ICU nurses (r=0.539, P < 0.01; r=0.387, P < 0.01). The management issues and interpersonal relationships, professional and career issues and emotional exhaustion had significant predictive power on normative commitment(r=0.458,P < 0.01). Conclusion It generally was in a higher level of job stress in ICU nurses, which indicates that hospital mangers should try to eliminate the causes ,assist them to reduce job stress and relieve the job burnout.

When mature adipocytes are subjected to an in vitro dedifferentiation strategy referred to as ceiling culture, these mature adipocytes can revert to dedifferentiated fat (DFAT) cells. DFAT cells have many advantages compared with adipose-derived stem cells (ASCs) and bone marrow mesenchymal stem cells (BMSCs). For example, DFAT cells are homogeneous and could be obtained from donors regardless of their age. Furthermore, DFAT cells also have the same multi-lineage potentials and low immunogenicity as ASCs. As an excellent source of seed cells for tissue engineering and stem cell transplantation, DFAT cells have better prospects in the treatment of many clinical diseases, such as bone defects, neurological diseases, ischemic heart disease and kidney disease. It is necessary to make more intensive studies of DFAT cells. This article summarizes progresses in the immunological characteristics, differentiation ability and potential clinical applications of DFAT cells.
Adipocytes ; cytology ; Cell Dedifferentiation ; Cell Differentiation ; Cells, Cultured ; Humans ; Stem Cell Transplantation ; Tissue Engineering

[Summary] The paper reported 9 cases of external type cesarean scar pregnancy treated with transvaginal local lesion resection between January 2013 and March 2014 in this hospital .The surgical exposure was established by using vaginal tractors .The cervical front lip was pulled below outwards by using cervical clamp to expose the front vaginal fornix .Hemostatic water was injected into the cervix vaginal clearance (epinephrine 0.5 mg +NS 500 ml).The vaginal mucosa was opened at bladder cervix groove level for entering the bladder cervix clearance .The bladder was seperated upwards and to the side with fingers to expose uterine isthmus lesions . After cutting the thin muscle , the embryos and part of necrotic tissues were extracted for pathological examination .The incision scar around tissues were trimed and a drainage tube was placed in the uterine .A myometrium full-thickness continuous suture was performed with 1-0 absorbable sutures ( paying attention to avoid endometrial tissues ) , and the vaginal wall was continuously sutured with 1-0 absorbable thread .The drainage tube was removed 5 days after operation .The operations were successfully accomplished in all the 9 cases.The average operation time was 65 min (40-90 min), and the average blood lose was 60 ml (40-80 ml).Cervical tube adhesion occurred in 1 case, and no complications were observed in the remaining cases .The average hospitalization time was 7.5 days (5-10 days).The postoperative time of menstruous restoration was 28-40 days.We deem that transvaginal resection of cesarean scar pregnancy lesion is simple and deserves clinical popularization .

Objective To investigate the expressions and correlations of Kiss-1 and matrix metalloproteinases-9 (MMP9) proteins in the colorectal cancer (CRC) tissues of patients with synchronous colorectal liver metastasis (SCRLM),and the association with the clinicopathologic factors and prognosis of patients.Methods The retrospective case-control study was adopted.The clinicopathological data of 96 patients with SCRLM and 69 patients with CRC and no metastasis who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2000 to May 2013 were collected.The 96 CRC tissues and 50 adjacent normal tissues (distance from resection margin ≥ 5 cm) were collected from 96 patients with SCRLM,and 69 CRC tissues were collected from 69 patients with CRC and no metastasis.Expressions of Kiss-1 and MMP9 protein were detected by immunohistochemistry (IHC).The follow-up of outpatient examination and telephone interview was performed to detect survival of patients till August 2014.Comparison of count data and correlation between expressions of Kiss-1 or MMP9 protein and clinicopathological factors were analyzed by the chi-square test and Fisher exact probability.Survival curve was drawn using the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Correlation analysis was done by the Pearson correlation.Results Expression of Kiss-1 protein was located in the cytoplasm of tissue cells.The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 24.0％ (23/96),43.5％ (30/69) and 52.0％ (26/50),respectively,with a significant difference among the 3 tissues (x2 =14.307,P ＜ 0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2 =0.845,P ＞ 0.05).The positive expression rate of Kiss-1 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =0.702,11.594,P ＜ 0.05).Expression of MMP9 protein was located in the cytoplasm of tissue cells.The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 67.7 ％ (65/96),62.3 ％ (43/69) and 36.0％ (18/50),respectively,with a significant difference among the 3 tissues (x2=14.203,P ＜0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2=8.038,P ＞ 0.05).The positive expression rate of MMP9 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =13.475,13.475,P ＜ 0.05).The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM were 66.7％,21.9％ and 17.6％ in the high-,mederate-and low-differentiated tumor,50.0％,28.6％ and 17.5％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 16.9％ in patients with and without lymph node metastasis,respectively,showing significant differences among the tumor differentiation degree,depth of tumor invasion and lymph node metastasis (x2=6.546,6.172,7.453,P ＜0.05).The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM were 25.0％,66.7％ and 76.2％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 76.1％ in patients with and without lymph node metastasis,respectively,showing significant differences between the depth of tumor invasion and lymph node metastasis (x2 =12.094,8.690,P ＜ 0.05).All the 96 patients with SCRLM were followed up for a median time of 68 months (range,12-176 months).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,26 months,69.6％ and 26.1％ in patients with SCRLM and positive expression of Kiss-1 protein and 26 months,19 months,24.7％ and 12.3％ in patients with SCRLM and negative expression of Kiss-1 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=16.578,14.436,P ＜ 0.05).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,19 months,24.6％ and 12.3％ in patients with SCRLM and positive expression of MMP9 protein and 28 months,16 months,58.1％ and 22.6％ in patients with SCRLM and negative expression of MMP9 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=14.073,8.532,P ＜0.05).Of 96 patients with SCRLM,there were 23 patients with positive expression of Kiss-1 protein (10 with positive expression of MMP9 protein and 13 with negative expression of MMP9 protein) and 73 with negative expression of Kiss-1 protein (55 with positive expression of MMP9 protein and 18 with negative expression of MMP9 protein),with a negative correlation between expressions of Kiss-1 protein and MMP9 protein (r =-0.291,P ＜ 0.05).Conclusions The reduced expression of Kiss-1 protein and elevated expression of MMP9 protein are closely associated with invasion and metastasis of CRC and prognosis of patients.A combination detection of Kiss-1 and MMP9 proteins is expected to become a marker for predicting the prognosis of patients with SCRLM based on the negative correlation between them.

Objective To compare the efficacy and safety of liquid nitrogen cryotherapy combined with acyclovir and mecobalamin in the treatment of herpes zoster in elderly patients.Methods 520 elderly patients with herpes zoster were randomly divided into two groups,experimental group and control group (n=260,each).Patients in experimental group were treated with liquid nitrogen cryotherapy,using liquid nitrogen cotton swab to graze the skin lesions 2-3 times per day for successive 5 days,combined with acyclovir and mecobalamin.Patients in control group were treated with acyclovir and mecobalamin.New blisters and dry skin and crust were observed and compared between the two groups on the 5th,14th,30th day after treatment.The skin lesion situation and reaction times for pain complete remission,vesicular scab,postherpetic neuralgia (PHN) were recorded and analyzed.Results The effective rate was 93.9％ (244/260) in the experimental group versus 84.2％ (219/260) in the control group (x2 =12.32,P＜ 0.05).The reaction times for vesicular scab,pain complete remission and subside were shorter in experimental group than in control group [(2.63 ±0.78)d vs.(4.75±1.39)d,(8.17±1.68)d vs.(11.25±2.23)d,(9.24±2.53)d vs.(12.78±3.13)d,all P＜0.01].There was no significant difference in new blister time between the experimental group and the control group [(1.85±0.62) d vs.(1.79±0.83)d,P＞0.05].Postherpetic neuralgia incidence was lower in experimental group than in control group [6.9％ (18/260) vs.18.1％ (47/260),x2 =14.79,P＜0.01].Conclusions Treatment with liquid nitrogen cryotherapy combined with acyclovir and mecobalamin can shorten the reaction times of vesicular scab,and pain complete remission and subside,and reduce postherpetic neuralgia as compared to acyclovir and mecobalamin treatment in elderly patients with herpes zoster.

Objective:To establish a method for the content determination of tetrahydropalmatine and imperatorin in Yuanhu Zhi-tong tablets by HPLC. Methods:An AKZONOBEL Kromasil 100-5 C18 column (250 mm × 4. 6 mm , 5μm) was used and the mobile phase consisted of methanol and 0. 1% phosphoric acid (52∶48) (adjusting pH to 6. 5 with triethylamine),the flow rate was 1. 0 ml· min-1 at the column temperature of 40℃, the detection wavelength was at 284 nm, and the injection volume was 10 μl. Results:The linear range of tetrahydropalmatine was 0.004 2-0.084 0 mg·ml-1(r=1.000 0). The average recovery was 97.72% with RSD of 1.10%(n=6). The linear range of imperatorin was 0.003 6-0.072 0 mg·ml-1(r=0.999 7). The average recovery was 97.99%with RSD of 0. 96%(n=6). The measurement results of 10 batches were stable and reliable. Conclusion:The method is simple and accurate, which can be used to improve the quality standard.

Purpose To explore the methods of selectively visualizing hepatic portal vein by using three-dimensional fast imaging employing steady state acquisition combined with in-flow inversion recovery labeling pulse at 3.0 Tesla. Materials and Methods Ten healthy volunteers were examined under different TI (1200, 1400, 1600, 1800 ms), and the vessel-to-liver contrast ratio of the main portal vein, right portal vein, and left portal vein were measured. Results Non-contrast-enhanced MRA images of portal vein were obtained successfully in all ten volunteers. The signal intensity of peripheral portal branches gradually increased when TI increased from 1200 ms to 1600 ms, and the highest vessel-to-liver contrast ratio occurred when TI was 1400 ms. Conclusion Non-contrast enhanced magnetic resonance angiography of the hepatic portal vein can be successfully achieved at 3.0T high field MRI. A fixed TI of 1400 ms is preferable.

Objective Our research aimed to investigate the efficacy and the nursing characteristics of allogenic bone marrow mesenchymal stem cell (BM-MSCs) transplantation in HBV related acute-on-chronic liver failure (ACLF) patients.Methods A total of 91 HBV related ACLF patients were enrolled,among whom 45 patients received allogenic BM-MSCs transplantation via peripheral vein and other 46 patients received medical treatment only.We assessed the 12-week survival rates and the variation of model for end liver disease (MELD) score.Besides,we administrated comprehensive nursing for these patients in different stages of the transplantation.Results The cumulated survival of patients received BM-MSC transplantation was 75.6％,which was higher than the control group (54.5％).The level of total bilirubin and International Normalized Ratio (INR) had greatly improved.41 of 45 patients passed through perioperative period safely,without any severe adverse events.11 patients died due to exacerbation of liver failure,among whom 3 happened in perioperative period.But none was related with the operation.Conclusions Allogenic BM-MSCs transplantation can improve the survival rate of HBV related ACLF patients.The psychological nursing pre-operation,skilled operation,intensive care and observation post operation were beneficial to the patients' recovery after transplantation.

Objective To explore the clinical efficacy and safety of cyclosporin A combined with glucocorti-costeroid in the treatment of juvenile uveitis.Methods 66 juvenile uveitis patients(93 eyes)were selected.Accord-ing to the conditions,the patients were treated by oral administration of cyclosporin A,2-5mg·kg -1 ·d -1 ,twice per day,combined with prednisone,0.5-1mg·kg -1 ·d -1 ,taken in the morning.After 4-6 months treatment,the inflam-mation control and visual acuity improvement were observed,and before and after treatment liver and kidney function, blood glucose,blood pressure,white blood cell counts were checked.Adverse reactions in patients were recorded with regular follow-up.Results After 4-6 months treatment,heal inflammation 78 eyes,accounted for 83.87%;improved 9 eyes,accounted for 9.68%;no respond in 6 eyes,accounted for 6.45%;the total effective rate was 93.55%.Visual acuity was obviously improved in 50 eyes,improved in 27 eyes and no response in 16 eyes;the total effective rate was 82.79%;56 eyes were removed from residual standard.In the stage of therapy,6 patients had liver and kidney dys-function,6 patients had blood abnormalities,and 3 patients had low blood sugar,all were controlled by symptomatic treatment in the normal range,and no systemic progression.Conclusion Cyclosporin A combined with glucocortico-steroid applied in juvenile uveitis improved the results with obvious clinical effect and fewer systemic side effect.