Objective To summarize the nursing experience of laparoscopy-assisted laparotomy for parastomal hernia.Methods The clinical nursing data of 27 patients with laparoscopy-assisted laparotomy for parastomal hernia were analyzed retrospectively.Results 27 patients were all performed successfully with a mean operation time of (108.0 ± 15.5)min.All patients were followed up for 6-48 months,and there were no intestinal obstruction,intestinal fistula,recurrent hernia,local hematoma,wound infection and fat liquefaction.Conclusion Operating room nurses should master the installation and maintenance attentions of laparoscopic and open surgery equipment and prepare surgical items and equipment accurately and familiar with the operation process and the characteristics of hernia repair in nursing process.Dynamic management of personnel flow in the whole process can reduce the risk of surgical incision infection.

Objective To analyze the correlation between health quotient and quality of life by investigated and studied the relationship between the two. Methods One hundred and ninty three caregivers of cancer patients were investigated by the general situation questionnaire, Health Quotient Questionnaire and Health Survey Short Form (SF-36). Results Different age, gender, education, marriage status, income, occupation, whether suffering from chronic diseases, physical examination frequency, care time and care relationship had a significant differences on quality of life of caregivers ( t/F=7.618-21.043, P < 0.05 or 0.01); the dimension scores of health quotient of caregivers were self-care (4.87±1.65) points, health knowledge (4.53±1.50) points, life style (4.47±1.65) points, state of mind (4.66± 1.87) points, life skills (4.73±1.78) points, were all on the alert value;caregiver′s level influenced by age, income, education level, occupation, whether suffering from chronic diseases and other factors (F=5.227-11.143, P<0.05);the dimension of health quotientand quality of life of caregivers were significantly correlated (r=0.506-0.771, P<0.01). Conclusions The status on quality of life and health quotient of caregivers are poor, and there is a positive correlation between the two, the level of health quotient is higher, the quality of life is better. Therefore, as for improving the quality of nursing care, clinical nursing staff should pay more attention to improve their health quotient level so as to improve the quality of life better.

Objective To evaluate the early outcomes of mini-open lumbar microdiscectomy. Methods There were 38 cases in each group of mini-open lumbar mierodiscectomy and conventional discecto- my.Operating time,blood loss,time of leaving the bed and length of hospital stay were compared in two groups.MacNab criteria were used to evaluate the outcomes.Results To compare the conventional discec- tomy group,microdiscectomy group spent similar operating time,but had less blood loss(P

OBJECTIVETo build sub-endplate microcirculation disturbance animal model and to investigate the potential pathogenesis of intervertebral disc degeneration (IVDD).

METHODSTwenty four New Zealand white rabbits were divided into treatment group (Group A) and control group (Group B). In Group A, animals received endotoxin and corticosteroid application to build sub-endplate microcirculation disturbance animal model, validated by microthrombus staining. In Group B, animals were given no drug, but standard feeding. After 3 month, the extent of IVDD was evaluated by the water content, biochemistry analysis, and morphology.

RESULTSSub-endplate microthrombus staining confirmed the exist of microcirculation disturbance. The water content and biochemistry components content of disc in Group A were lower than those of disc in Group B, and IVDD was observed in morphology.

CONCLUSIONSub-endplate microcirculation disturbance can directly contribute to IVDD, the nutrients diffusion barrier is the potential pathogenesis of IVDD.

Animals ; Disease Models, Animal ; Female ; Intervertebral Disc ; blood supply ; metabolism ; pathology ; Male ; Microcirculation ; Rabbits ; Random Allocation ; Thrombosis ; complications ; metabolism ; pathology

OBJECTIVETo evaluate the efficacy of hBMP-4 gene modified tissue engineered bone graft in the enhancement of rabbit spinal fusion and find an ideal kind of substitute for the autograft bone.

METHODSRabbit BMSCs were cultured and transfected with AAV-hBMP-4 using different MOI value. The optimal MOI value were determined by observing cell's morphology change. BMSCs were then transfected with AAV-hBMP4 and AAV-EGFP respectively, following which the transfected cells were evenly suspended in a collagen sponge I, and implanted to either side of the L5,6 intertransverse spaces posterolateral in the New Zealand rabbits to induce spinal fusion. Fourteen rabbits were randomly divided into 2 groups. Group 1: AAV-hBMP-4 transfected BMSCs in the right side (hBMP-4 side) and autograft bone in the left side. Group 2: AAV-hBMP-4 transfected BMSCs in the right side (hBMP-4 side) and AAV-EGFP transfected BMSCs in the left side (EGFP side). Radiographs and three-dimensional CT of the spine, manual palpation, gross and histological examination of the fusion masses for all the animals were performed subsequent to animals having been sacrificed at 12 weeks after surgery.

RESULTSEvaluation has been taken in 12 New Zealand rabbits delivered into 2 groups which meet the criterion after operation. Eleven in 12 implemented sides involved hBMP-4 achieved bony fusion, to which 5 in 6 autografted sides was similar. But only 2 in 6 sides in EGFP-group achieved bony fusion meanwhile. Three-dimensional CT scan and palpation also evidenced the results. Bone formation was observed obviously on specimen both in hBMP4 sides and autografted ones. EGFP-group also got bony integration, but the quantity was small.

CONCLUSIONTissue-engineered bone graft constructed from application of hBMP4 is a fine substitute for autograft. Effective enhancement of bony integration in spinal fusion surgery has been evidenced in vivo.

Animals ; Bone Morphogenetic Protein 4 ; genetics ; Bone Regeneration ; Bone Substitutes ; Bone Transplantation ; methods ; Genetic Vectors ; Lentivirus ; genetics ; Male ; Myeloid Progenitor Cells ; Rabbits ; Random Allocation ; Spinal Fusion ; methods ; Stromal Cells ; Tissue Engineering ; Transfection

OBJECTIVETo investigate the molecular mechanism of TFE (total flavone of epimedium) in the treatment of osteoporosis, and then provide experimental evidence for modernization and further development of TFE as an traditional Chinese medicine.

METHODSSixty healthy female SD rats with aged 4 months were randomly divided into three groups (including control group in which rats received sham surgery, OVX group in which ovariectomized rats didn't give any medicine after the removal of ovaries and TFE group in which ovariectomized rats administrated TFE), 20 rats in each group. Compared bone mineral density (BMD) between before operation and at 4th week after operation in order to verify the establishment of osteoporotic model (criteria: BMD decreased more than 20% at 4th week after operation). The rats in TEF group were administrated total flavone of epimedium(concentration 30 mg/ml, 10 ml/kg, qd) orally for 4 weeks. After this, killed rats to harvest the lower part of the femur and detected BMD again. Applying the reverse transcriptase-polymerase chain reaction technique (RT-PCR) to detect expression of OPG, OPGL mRNA in bone tissue.

RESULTS(1) At 4th week after ovariectomy, the mean BMD of lumbar vertebra in TFE group fell to (0.084 +/- 0.020) g/cm2. Administrated with TFE for 4 weeks,the BMD increased to (0.112 +/- 0.009) g/cm2. There was significant improvement compare with the OVX group (P < 0.05). (2) Compared between OVX group and TFE group, The OPG mRNA expression of TFE group obviously enhanced. There was significant difference in statistics (P < 0.05). However,the promotion for OPGL mRNA expression were detected between OVX group and TFE group,there was no significant difference in statistics (P > 0.05).

CONCLUSIONThis study showed that TFE could inhibit differentiation and maturation of osteoclast through enhancing OPG mRNA expression, accordingly,to treat osteoporosis.

Animals ; Bone Density ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Epimedium ; chemistry ; Female ; Flavones ; Flavonoids ; pharmacology ; Gene Expression Regulation ; drug effects ; Osteoblasts ; drug effects ; metabolism ; physiology ; Osteoprotegerin ; genetics ; Ovariectomy ; RANK Ligand ; genetics ; RNA, Messenger ; genetics ; metabolism ; Rats

OBJECTIVETo biomechanically compare the stability of the short and long iliac screw fixation constructs in lumbo-iliac reconstruction.

METHODSSeven adult human embalmed cadavers (L(3)-pelvis) were used. Using posterior spinal fixation system, L(4)-S(1) pedicle screw fixation was performed. This was defined as intact state of the sacroiliac joint. After the intact test, total sacrum resection and L(4)-L(5)-pelvis reconstruction by pedicle screw and iliac screw with different lengths were performed as follow: short screw group (as the length of exceeding 2 mm over ischial notch) and long screw group (as the length of exceeding 2 mm over anterior inferior iliac spine). Using the 858 MTS material testing machine, biomechanical testing was performed under 800 N compression and 7 Nm torsion loading modes. At last, the axial pullout test of two iliac screws was executed. Construct stiffness in compression and torsion test, and maximum pullout force were analyzed.

RESULTSInsertion lengths of the short and long iliac screw were (70 +/- 2) mm and (138 +/- 4) mm respectively. The lumbo-pelvic reconstruction using short and long iliac screw, respectively restored 53.3% +/- 13.6% and 57.6% +/- 16.2% of the initial stiffness in compression testing, and respectively harvested 55.1% +/- 11.9% and 62.5% +/- 9.2% of the initial stiffness in torsion testing. No significant difference was detected between the two reconstructions (P > 0.05), however, the compressive and torsional stiffness of the two techniques were markedly less than the intact condition (P < 0.05). The maximum pullout strength of long iliac screw was significantly higher than short screw (P < 0.05).

CONCLUSIONSUnder the physical loading, lumbo-pelvic fixation construct using the short iliac screw may obtain mechanical stability comparable to that by long iliac screw. The short iliac screw is only the half of the long iliac screw by length, could reduce the implantation risk. However, the long iliac screw behaves greater axial pullout force, should be applied as far as possible in the osteoporosis patient. The lumbo-pelvic reconstruction utilizing any length of iliac screw is difficult to restore the local stability.

Adult ; Aged ; Biomechanical Phenomena ; Bone Screws ; Female ; Humans ; Ilium ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Sacrum ; surgery ; Spinal Fusion ; methods

OBJECTIVETo observe Notch1 expression in esophageal squamous cell carcinoma (ESCC) and investigate its relation with microvascular angiogenesis in the tumor.

METHODSTissue slices of 40 cases ESCC (cancer group) and 8 cases normal esophagus tissues (normal group) were obtained to analyze the expression of Notch1 and vascular endothelial growth factor (VEGF) using immunohistochemistry and estimate the microvessel density (MVD) in the tumor.

RESULTSNotch1 expression was significantly lower in the cancer group than in the normal group (P<0.05). In the cancer group, Notch1 expression was higher in highly differentiated than in poorly differentiated tumors (P<0.05) regardless of tumor infiltration or lymph nodes metastasis (P>0.05). VEGF expression and MVD were significantly higher in cancer group than in normal group, and showed significant differences between tumors with different differentiation degrees, infiltration and lymph node metastasis (P<0.05). Correlation analysis showed that Notch1 expression was inversely correlated to VEGF expression.

CONCLUSIONNotch1 may be an anti-oncogene in ESCC and affects cell differentiation in early stage of the malignancy. Abnormally low expression of Notch1 in ESCC may be one of the upstream factors to induce high expression of VEGF and increased MVD. The Notch1 pathway might play a key role in microvascular angiogenesis in ESCC.

Adult ; Aged ; Angiogenesis Inducing Agents ; metabolism ; Capillaries ; growth & development ; Carcinoma, Squamous Cell ; blood supply ; metabolism ; Esophageal Neoplasms ; blood supply ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; Receptor, Notch1 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

Objective To investigate the effects of trifluridine-tipiracil hydrochloride tablets(TAS-102)combined with oxaliplatin(L-OHP)on proliferation,migration,invasion and apoptosis of hepatocellular carcinoma SNU-449 cells and its possible mechanism.Methods SNU-449 cells were divided into control group(without drugs),TAS-102 group(2 μg·mL-1),oxaliplatin group(1.2 μg·mL-1)and combination group(2 μg·mL-1 TAS-102+1.2 μg·mL-1 L-OHP).Cell counting kit-8 assay was used to detect cell proliferation ability;Transwell assay was used to detect cell migration and invasion;the apoptosis rate was analyzed by flow cytometry;the expressions of B-cell lymphoma-2(Bcl-2),Bel-2-associated X(Bax),E-cadherin and Vimentin were detected using Western blotting.Results Survival rate of cells in control group,TAS-102 group,oxaliplatin group and combination group were(100.00±2.98)％,(80.26±5.55)％,(78.49±5.76)％and(47.82±4.26)％,respectively;the number of cell migration were 436.83±27.50,228.17±15.87,171.67±19.49 and 113.83±11.34,respectively;the number of cell invasion were 332.67±19.95,205.33±13.65,219.67±14.49 and 116.83±11.30,respectively;the apoptosis rates were(2.32±0.07)％,(6.74±0.24)％,(6.37±0.18)％and(10.67±0.41)％,respectively;the relative expression levels of Bax protein were 0.28±0.01,0.53±0.03,0.75±0.03 and 1.11±0.03,respectively;the relative expression levels of Bel-2 protein were 0.65±0.03,0.32±0.02,0.23±0.02 and 0.13±0.01,respectively;the relative expression levels of E-cadherin were 0.15±0.01,0.24±0.02,0.35±0.02 and 0.64±0.02,respectively;the relative expression levels of Vimentin were 0.65±0.03,0.27±0.01,0.34±0.02 and 0.18±0.01,respectively.Comparison of each treatment group with the control group and comparison of the combination group with monotherapy group,the above indexes were statistically significant(all P＜0.05).Conclusion The synergistic effect of TAS-102 and oxaliplatin enhanced the inhibitionon proliferation,migration,and invasion,and promoted cell apoptosis of SNU-449 cells,and the mechanism may be related to the promotion of Bax and E-cadherin proteins and the inhibition of Bel-2 and Vimentin proteins.

Objective To explore the correlation of serum matrix metalloproteinase-2 (MMP-2) and tissue metalloproteinase inhibitor-2 (TIMP-2) levels to carotid atherosclerosis plaque vulnerability in patients with anterior circulation infarction. Methods Sixty patients with anterior circulation infarction and 38 healthy volunteers were enrolled in this study. Color Doppler ultrasonography of the carotid artery was performed to determine the carotid intima-media thickness (IMT), Crouse plaque integral (CPI) score, and the total carotid plaque area (CPA). According to the nature of the carotid atherosclerosis plaque defined by ultrasonography, the patients were divided into vulnerable plaque (VP) group (33 cases), stable plaque (SP) group (27 cases), and no plaque (NP) group (38 cases). Serum MMP-2 and TIMP-2 levels were detected in these subjects using enzyme-linked immnosorbent assay (ELISA). Results Ultrasonography showed significantly greater/MT, CPI and CPA in VP group than in SP and NP groups (P<0.05). Serum MMP-2 level was significantly elevated in VP group as compared with that in SP and NP groups (P<0.05). Serum TIMP-2 level was significantly lower in VP group than in SP and NP groups (P<0.05). In VP group, serum MMP-2 level and MMP-2/TIMP-2 ratio were found to positively correlate to IMT, CPl and CPA (r=0.961, 0.966, and 0.804 for MMP-2, respectively, P<0.05;r=0.625, 0.709, and 0.651 for MMP-2/TIMP-2 ratio, respectively, P<0.05), while TIMP-2 was inversely correlated to IMT, CPI and CPA (r=-0.944, -0.996, and -0.859, respectively, P<0.05). Conclusion Serum MMP-2 and TIMP-2 levels and MMP-2/TIMP-2 ratio are closely correlated to carotid atherosclerosis plaque vulnerability.