According to the operational principle of original switch K2 for the console of orthopantomography X-ray unit, the common switch K1 and some accessory circuits are used to improve K2.

Objective To explore clinical application of retrograde medial and lateral gastrocnemius muscle flap for soft tissue defects of the middle and lower third of the leg. Methods From August 2008 to December 2009, in our hospital we adopted retrograde medial and lateral gastrocnemius muscle flap to renovate 5 cases of refractory soft tissue defects of the middle and lower third of the leg. Results Five cases of retrograde medial gastrocnemius muscle flap were survived, morphology and function of soft tissue defects were renovated well. Conclusion This operation is an effective and reliable technique for soft tissue defects of the middle and lower third of the leg, which is performed without sacrificing the major blood vessels, probing vascular pedicle and matching vascular anastomosis.

Objective To introduce clinical application of retrograde medial pedicled skin flap of the leg to repair the plantar cutaneous deficiency. Methods From January 2002 to May 2008, in our hospital we adopted retrograde medial pedicled skin flap to renovate 12 cases of plantar cutaneous deficiency. The size of the skin flaps ranged from 10 cm× 7 cm to 13 cm × 12 cm. Results Ten cases of retrograde medial pedicled skin flap were survived, the rest had partial necrosis because of distal blood flow obstacle. One was cured by changing dressings; the other was repaired by secondary operation. Morphology and function of soft tissue defects were renovated well with 6-18 months follow-up. Conclusion This operation is an effective and reliable technique for plantar cutaneous deficiency.

Objective:To investigate the correlation of sleep disorders(SD)with serum levels of amyloid β-proteins(Aβ 1-42)and tau phosphorylated at threonine(P-Tau 181)in patients with Alzheimer's disease(AD). Methods:A total of 126 patients with mild and moderate AD who met the inclusion criteria in the memory clinic, sleep clinic and geriatrics department of Jianghan Oilfield General Hospital affiliated to Yangtze University from February 2017 to January 2020 were included.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate sleep quality.Patients with PSQI scores ≥7 were included in the AD group with sleep disorders(AD-SD group), and patients with PSQI scores <7 were included in the AD group without sleep disorders(AD-NSD group). The Montreal Cognitive Assessment(MoCA), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), Hamilton Rating Scale for Depression(HRSD)and Hamilton Anxiety Rating Scale(HAM-A)were used to evaluate cognitive and psychosocial symptoms.During the same time, biological markers such as serum Aβ 1-42, Aβ 1-40 and P-Tau 181 were detected by using enzyme-linked immunosorbent assays.Patients in the two groups received donepezil as an anti-dementia therapy, while the AD-SD group was treated additionally with a targeted sleep intervention.All patients underwent neuropsychological assessment and biochemical tests at enrollment and at the end of the 6th month, and results from all parameters at baseline and at the end of the 6th month were compared.At the end of the six-month treatment, patients in the AD-SD group were further divided into the recovery AD-SD sub-group and the no-recovery AD-SD sub-group based on the extent of sleep improvement. Results:Of the 126 AD patients, 93(73.8%)had sleep disorders.There was no statistically significant difference between the two groups in gender, age, onset age, educational level, course of disease, CDR, GDS, MoCA, Aβ 1-40 or Aβ 1-42/Aβ 1-40(all P>0.05). The scores of PSQI, HRSD and HAM-A and serum levels of Aβ 1-42 and p-Tau 181 showed statistically significant differences between the AD-ND and AD-NSD groups( P<0.05 or P<0.01). At the end of the 6th month, the scores of PSQI, GDS, HRSD and HAM-A and levels of Aβ 1-42, Aβ 1-40, and P-Tau 181 also showed statistically significant differences between the AD-ND and AD-NSD groups( P<0.05 or P<0.01). There was no statistically significant difference in results from other parameters( P>0.05). Spearman correlation analysis showed that PSQI was correlated with HRSD( r=0.271, P=0.009), HAM-A( r=0.479, P=0.000), Aβ 1-42( r=0.470, P=0.000), Aβ 1-42/ Aβ 1-40( r=0.479, P=0.000)and P-Tau 181( r=0.371, P=0.000)in the AD-SD group at baseline.Multivariate Logistic regression model showed that serum Aβ 1-42 and P-Tau 181 levels and HRSD had predictive effects on changes in sleep quality in AD patients( OR=1.897, 1.269 and 1.889, P=0.000, 0.003 and 0.000). The areas under the receiver operating characteristic(ROC)curves for Aβ 1-42, P-Tau 181 and HRSD were 0.926(95% CI: 0.860-0.991), 0.837(95% CI: 0.746-0.927)and 0.854(95% CI: 0.776-0.932), respectively. Conclusions:Sleep quality is correlated with serum Aβ 1-42and P-Tau 181 levels in AD patients.Elevated serum levels of Aβ 1-42 and P-Tau 181 and high HRSD scores are important predictors of SD in AD patients and may be used as indexes for clinical treatment efficacy.

BACKGROUND:The obesity has led to a plenty of diseases including hypertension, coronary heart disease, fatty liver, hyperlipidemia, and type 2 diabetes. Therefore, understanding the mechanism of adipocyte differentiation is of far-reaching significance to the prevention and treatment of obesity. For the current studies of the mechanism of adipocyte differentiation pay more attention to microRNA, rather than long non-coding RNAs (lncRNAs). OBJECTIVE:To obtain the lncRNAs whose fold change was apparent during adipogenic differentiation, and to further screen the lncRNAs that possibly play a crucial role in adipogenic differentiation for verification. METHODS:Subcutaneous fat was obtained from human abdomen. Adipose-derived stem cells were col ected using tissue culture method. The third passage of adipose-derived stem cells was used for adipogenic differentiation. Through microarray technology, the expression levels of lncRNAs and mRNA were analyzed at 0, 5 and 12 days in adipogenic differentiation. Combining with bioinformatics report, lncRNAs apparently presented fold change were screened and verified by qRT-PCR. RESULTS AND CONCLUSION:Fold change 1.5 (P<0.05) was considered as a criterion during adipogenic differentiation. The number of up-regulated lncRNAs was 748 for 5 days versus 0 day, 847 for 12 days versus 0 days, 593 for 12 days versus 5 days. At the same time, the down-regulated number was 828 for 5 days versus 0 day, 1 113 for 12 days versus 0 day, 750 for 12 days versus 5 days during adipogenic differentiation. In combination with bioinformatics analysis results, 3 of 28 lncRNAs were related to lipid metabolism:AK304548, BP216319 and DA852857, according to the standard that fold change in 0, 5 and 12 days was higher, and the target genes were known to be associated with adipogenesis-related genes. PCR results showed that the expression of AK304548 and BP216319 and its target gene presented an up-down trend, which is consistent with the microarray sequencing results. These results indicated that lncRNA plays a critical regulatory role in the adipogenic differentiation.

Objective To explore the effects of ecoimmunonutrition support on the intestinal barrier function and pancreas in rats with severe acute pancreatitis (SAP). Methods Totally 64 SPF rats were randomly divided into sham operation group (control group) , SAP without enteral nutrition support group (SAP group), SAP with early enteral nutrition support group (EEN group), and SAP with early ecoimmunonutrition support group (EIN group). Bacteria translocation (BT), plasma endotoxin (ET) , gut permeability, pancreas pathology score,and distant ileum pathology were determined on the 4th and 7th post-modeling day. Results The BT rate was significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜ 0.05), was significantly lower in EEN group and EIN group than in SAP group (P ＜ 0.05), and was significantly lower in EIN group than in EEN group (P ＜ 0.05). ET and FD-40 levels in blood were both significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜0.01)and were significantly lower in EIN group and EEN group than in SAP group (P ＜0.01); ET was significantly lower in EIN group than in control group (P ＜0.05). Pathological scores were significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜0.01)and were significantly lower in EEN group and EIN group than in SAP group (P ＜ 0.01). The individual pathological scores of EIN group were not significantly different from EEN group (P ＞ 0.05), while the total score was significantly lower in EIN group than in EEN group (P ＞ 0.05). Distant iliac mucosa was significantly thicker in EIN group than in other groups. Conclusions Early enteral nutrition support protects the intestinal barrier and pancreas in rats with SAP. Ecoimmunonutrition has better nutritional effectiveness than the normal enteral nutrition.

Objective To analyze the clinical factors for pathologic complete response ( pCR) after preoperative neoadjuvant chemoradiotherapy ( neo?CRT) for locally advanced rectal cancer. Methods From 2005 to 2012, 297 patients with locally advanced rectal cancer and complete clinical data were enrolled as subjects. Those patients were diagnosed with biopsy and treated with neo?CRT ( radiotherapy by 3?dimonsional conformal radiotherapy or volumetric?modulated arc therapy) followed by radical surgery. The logistic regression model was used for the multivariate analyses of the correlation of pCR with age, gender, distance between tumor and the anal verge, serum level of carcinoembryonic antigen ( CEA ) before treatment, hemoglobin level before treatment, cT staging, and cN staging. Results In all patients, 78 ( 26?7%) patients had pCR after treatment. The numbers of patients with pCR were 42( 34?4%) in patients with stage T1?T3 disease and 37(21?1%) in patients with stage T4 disease. In the patients with serum CEA levels no higher than 5?33 ng/ml, 55(36?4%) had pCR after treatment, while in the patients with serum CEA levels higher than 5?33 ng/ml, only 24( 16?4%) had pCR. The univariate analysis revealed that age, gender, distance between tumor and the anal verge, anemia before treatment, or cN staging were not related to pCR. The multivariate analysis showed that stage cT1?T3 and a serum CEA level no higher than 5?33 ng/ml before treatment were influencing factors for pCR after neo?CRT for locally advanced rectal cancer ( P=0?031,P=0?000) . Conclusions The clinical staging and the serum CEA level before treatment are influencing factors for pCR after neo?CRT for locally advanced rectal cancer. The serum CEA level before treatment can be considered as a predictor of pCR after neo?CRT for locally advanced rectal cancer.

Wave intensity (WI) is a newly proposed hemodynamic index that assesses the working condition of cardiovascular system. The purpose of this study is to investigate the clinical value of WI in assessing the function of cardiovascular system in patients with chronic heart failure (CHF). We used a combined Doppler and echo-tracking system to calculate the carotid artery WI in 16 patients with CHF and 35 normal subjects, and examined the characteristics of WI. The main WI indices included W1, W2, NA, R-W1 and W1-W2. Compared with those in the control group, W1 and W2 were significantly decreased in CHF group (5.44 +/- 3.24 vs. 10.05 +/- 46.33, P < 0.01, 0.83 +/- 0.42 vs. 1.50 +/- 0.95, P < 0.01, respectively), the temporal indices R-W1 shortened (141.06 +/- 41.14 vs. 109.77 +/- 22.50, P < 0.05) and W1-W2 prolonged (214.63 +/- 39.93 vs. 260.51 +/- 20.58, P < 0.01), and the (R-W1)/(W1-W2) ratio was significantly larger in CHF group (0.69 +/- 0.26 vs. 0.43 +/- 0.10, P < 0.01). WI provides a great deal of information about the dynamic behavior of the interaction between the heart and vascular system, so it is a new quantitative approach for analysis of CHF.
Adult ; Aged ; Blood Flow Velocity ; Blood Pressure ; Carotid Arteries ; diagnostic imaging ; physiopathology ; Chronic Disease ; Echocardiography, Doppler, Color ; Female ; Heart Failure ; diagnostic imaging ; physiopathology ; Hemodynamics ; physiology ; Humans ; Male ; Middle Aged

Objective To establish the items framework of transcultural nursing self-management education for patients with chronic heart failure( CHF) . Methods Delphi method was used in this study. The items framework of transcultural nursing self-management education for patients with CHF was developed based on two rounds of consultation among 17 experts. Results The response rates of questionnaires of two rounds of expert consultation were 100%. And the authority coefficient, determine coefficient and degree of familiarity were 0. 895, 0. 850 and 0. 940, respectively. The items framework of transcultural nursing self-management education for patients with CHF consisted of 10 one-levels entries, 29 two-levels entries and 117 three-levels entries. Conclusions The items framework with good scientifically and practicability is based on the transcultural nursing theory, and provides scientific basis for the practice of personalized self-management education.

OBJECTIVETo construct eukaryotic expression vectors for different domains (V and VC1) of the extracellular region of the receptor of advanced glycation end products (RAGE) and investigate the roles of these domains in prostate cancer.

METHODSThe coding sequence of V and VC1 domains was amplified from the plasmid pcDNA3-HA-RAGE by PCR and cloned into the pcDNA3-HA vector following routine procedures. After identification by PCR and sequencing, the vectors including V and VC1 domains were transfected into PC-3 cells. Western blotting and immunofluorescence were used to detect the expression and distribution of the expressed products in transfected PC-3 cells.

RESULTSThe expression vectors containing V and VC1 domains of RAGE were successfully constructed as confirmed by PCR and DNA sequence analysis. The V and VC1 domains of RAGE were highly expressed and showed a cytoplasmic distribution in transfected PC-3 cells.

CONCLUSIONThe constructed eukaryotic expression vectors for V and VC1 domains of RAGE can be efficiently expressed in prostate cancer cells.

Cell Line, Tumor ; Cloning, Molecular ; Genetic Vectors ; Humans ; Male ; Plasmids ; Prostatic Neoplasms ; genetics ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Sequence Analysis, DNA ; Transfection