Objective: To propose a method for making organ-on-a-chip based on 3D printing, and study the relationship between cell growth on the chips and various factors. Methods: Through 3D printing technology and surface microstructure transfer method, ulcer-like and ridge-like mi-crostructures of the tumor surface and the intestinal villi were fabricated on a polydimethylsiloxane (PDMS) chip. Combined with fluorescence imaging, the effects of surface modification, shapes and heights of microstructures, and culture time on the surface coverage and density of Caco-2 cells on the chip were measured. Results:The PDMS chip was more likely to induce cell adhesion and growth rather than the 3D printing resin chip. On the surface of three-dimensional structure, cell surface coverage and cell density increased after the surface was treated with rat tail collagen (P<0.05). The height of surface structure of the chip affected the cell density (P=0.000). After surface modification, there was no significant difference in cell density at the same height of different steric structure (P>0.05). Conclusion: The intestinal villi and tumor topological organ chips can be fabricated by 3D printing technology and surface microstructure transfer method. The surface modification and microstructure height affect the cell growth on the surface.

Objective To explore the experience of developing evidence-based nursing (EBN) course in postgraduate nursing program in order to improve the quality of course.Methods A comprehensive project on developing EBN course for postgraduate nursing students was initiated in School of Nursing Fudan University.59 postgraduate nursing students in school of nursing, Fudan University were conveniently classified into EBN teaching group (n = 33) and control group (n = 26).The students in the EBN teaching group received 54 credit hours evidence-based nursing education.The teaching and learning experience were reflected through faculty interview and student interview. The teaching and learning outcome were evaluated by self-designed questionnaires.Results Students considered EBN course as a challenge.They experienced both positive and negative feelings during learning EBN.The critical appraisal, data extraction, Meta analysis and evidences utilization were seen as bigger challenges. However, they valued the experience of learning EBN as the opportunity for them to integrate knowledge and skill of literature searching, clinical epidemiology, health statistics, and nursing research into the learning of EBN course. Students in EBN teaching group had significantly higher score on evidence-based nursing knowledge than control group (z = 3.582, P < 0.01).Students in EBN teaching group had significantly higher scores on critical appraisal at post-course than at pre-course(t = 3.674,P < 0.01).Most of the students in EBN teaching group were satisfied with course content, teaching materials and teaching methods.In addition, they proposed constructive suggestions on credit hours and teaching arrangement for further implementing of evidence-based nursing course.Conclusions It is suggested that EBN can be developed as a course in postgraduate nursing program.The knowledge and skills on critical appraisal of literature and conducting systematic review can be improved by learning a comprehensive EBN course.However,the course content and teaching methods need further explore.

Objective To evaluate the outcome of the comprehensive evidence-based nursing course on Postgraduate training courses students. Methods Postgraduate training courses students in school of nursing of Fudan University were conveniently assigned to experimental group ( n =22) and control group ( n = 26). The students in the experimental group received 36 hours evidence-based nursing education. The teaching and learning outcome were evaluated by self-designed questionnaires. Results After 36 hours teaching and learning, Students in experimental group got significantly higher score on evidence-based nursing knowledge and literature criticism than control group(Z =3. 582,P<0. 01; t =3. 674,P<0. 01) ; There was no statistical difference on evidence-based nursing attitude score of students in experimental group and control group after evidence-based nursing course(t = 0. 310,P >0. 05); The results of course feedback questionnaire suggested that most of the students in experimental group were satisfied with course content, teaching materials and teaching methods. Interview results showed that students can develop system evaluation and practice Evidence-based nursing. In addition, they proposed constructive suggestions on credit hours and teaching arrangement for further implementing of evidence-based nursing course. Conclusions The knowledge and skill of EBN could be significantly improved by learning a comprehensive evidence-based nursing course for nurses studied in postgraduate nursing Program. Further study is needed to explore the effect of EBN course on students' attitude to evidence-based nursing.

Objective:To investigate the effects of preoperative nutritional status on postoperative functional prognosis in elderly patients with proximal humerus fracture.Methods:From January 2020 to December 2020, 103 elderly patients (≥65 years old) were treated for proximal humerus fractures by open reduction and internal fixation at Department of Traumatology, Honghui Hospital Affiliated to Xi'an Jiaotong University. Upon admission, according to the Geriatric Nutrition Risk Index (GNRI), they were assigned into a normal nutrition group (55 cases, with GNRI≥92) and a malnutrition group (48 cases, with GNRI<92). The baseline data, preoperative hemoglobin level, time from injury to operation, intraoperative blood transfusion, postoperative complications, 1-year mortality, and Neer shoulder functional scores at 3 months, 6 months and the last follow-up were compared between the 2 groups.Results:The 2 groups were comparable because there were no significant differences in gender, injury side, Neer fracture classification, injury cause, or American Society of Anesthesiologists (ASA) grading ( P>0.05). The age of the malnutrition group was significant older than that of the normal nutrition group ( P<0.05). All patients were followed up for 9 to 16 months (mean, 13.6 months) after surgery. In the normal nutrition group and the malnutrition group, respectively, the preoperative hemoglobin level was (10.24±0.68) g/dL and (8.94±0.89) g/dL, the time from injury to operation (3.9±1.3) d and (5.8±1.2) d, the rate of intraoperative blood transfusion 14.5%(8/55) and 60.4%(29/48), the rate of postoperative complications 20.0%(11/55) and 39.6%(19/48), the 1-year mortality 1.8%(1/55)、4.2%(2/48), and the Neer shoulder function score (46.7±8.8) points and (43.2±5.6) points at 3 months after operation, (67.6±6.2) points and (76.3±5.5) points at 6 months after operation, and (80.4±5.0) points and (76.3±5.5) points at the last follow-up. Comparisons of all the above items showed significant differences between the 2 groups (all P<0.05). Conclusions:Preoperative malnutrition in elderly patients with proximal humerus fracture has adverse effects on preoperative waiting time, intraoperative blood transfusion, complications and postoperative shoulder function. Therefore, perioperatively, attention should be paid to the nutritional status of elderly patients to reduce their stress responses to fracture, surgery and anesthesia, and to improve their postoperative function and quality of life.

BACKGROUNDA new technique developed in 2002, real time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), has been one of the most important tools in lymph nodes (LNs) staging before lung cancer surgery. EBUS-TBNA was introduced into China in 2008.

METHODSBetween June 2009 and October 2009, 30 patients with mediastinal/hilar lymphadenopathy and thoracic masses previously detected with CT scan underwent EBUS-TBNA without rapid onsite cytological examination.

RESULTSFrom 30 patients, 33 samples were obtained from LNs and seven samples from intrapulmonary lesions. Twenty out of the 23 lung cancer diagnoses were clarified through the procedure, with sensitivity, specificity, positive predictive value, negative predictive value and accuracy being 87%, 100%, 100%, 70% and 90%, respectively. All three false negative cases were found in the first five procedures. Additionally, among the 33 LNs examined, three specimens that had no lymphocytes were also found within the first five procedures. There were no major complications, and the procedures were uneventful.

CONCLUSIONSEBUS-TBNA seems a safe and effective technique in making diagnosis for mediastinal/hilar LNs and intrapulmonary masses. For pulmonologists experienced in bronchoscopy, the sensitivity of the procedure for diagnosing lung cancer should be no less than 90% after the initial five procedures.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Bronchoscopy ; methods ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged

OBJECTIVETo explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma (EDH).

METHODSRetrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005. Sixty-five patients were treated with mini-invasive negative pressure drainage (treatment group), 70 patients with comparable condition used traditional craniotomy (control group). The mean time of operation, average days in hospital, expenditure and prognosis of two groups were recorded and analyzed.

RESULTSThere was no significant difference in therapeutic efficacy between two groups. Patients in treatment group had a shorter hospital stay and less expenditure than those in control group.

CONCLUSIONMini-invasive negative pressure drainage is simple, effective, economical and applicable to some traumatic EDH patients.

Brain Injuries ; complications ; Female ; Hematoma, Epidural, Cranial ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Retrospective Studies

AIMTo investigate the effect of resveratrol on EMMPRIN expression of macrophages.

METHODSHuman monocytic cell line THP-1 cells were co-cultured with EMMPRIN-highly-expressed MCF-7 cells; MMP-9 production was assayed by zymography. THP-1 cells were induced by PMA, expression of EMMPRIN was assayed by Western blotting. Cells were treated with resveratrol or PPARgamma agonist--pioglitazone during differentiation, EMMPRIN expression and MMP-9 activity were assayed. U937 cells were co-transfected with PPARy expression and luciferase-coding reporter vector, then cultured with pioglitazone or resveratrol, the activating capability of resveratrol on PPARgamma was evaluated by measuring the luciferase activity. THP-1 cells were pretreated with PPARgamma antagonist--GW9662 before pioglitazone or resveratrol treatment, then assayed for EMMPRIN expression and MMP-9 production.

RESULTSEMMPRIN expression was greatly increased during the differentiation from monocytes to macrophages; co-culturing with MCF-7 cells significantly increased MMP-9 production by monocytes. Both resveratrol and pioglitazone markedly inhibited EMMPRIN expression during monocytes differentiation. Resveratrol significantly activated PPARgamma and GW9662 greatly decreased the effect of resveratrol on EMMPRIN and MMP-9.

CONCLUSIONEMMPRIN expression is greatly up-regulated from monocytes to macrophages, which may play a role in inducing MMPs production by monocytes/macrophages. Resveratrol can significantly inhibit EMMPRIN expression via activating PPARgamma, which may be the underlying mechanism of its inhibitory effect on MMPs production by monocytes/macrophages.

Anilides ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Basigin ; biosynthesis ; genetics ; Blotting, Western ; Breast Neoplasms ; metabolism ; pathology ; Cell Differentiation ; drug effects ; Cell Line ; Cell Line, Tumor ; Coculture Techniques ; Dose-Response Relationship, Drug ; Female ; Humans ; Luciferases ; genetics ; metabolism ; Macrophages ; cytology ; drug effects ; metabolism ; Matrix Metalloproteinase 9 ; biosynthesis ; Monocytes ; cytology ; drug effects ; metabolism ; PPAR gamma ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Stilbenes ; pharmacology ; Thiazolidinediones ; pharmacology ; U937 Cells

Objective To establish a HPLC-MS/MS method for deter-mination of human plasma concentrations of Bezafibrate , and for the study of pharmacokinetic characteristics of bezafibrate ( two formulations ) . Methods Chromatographic separation was using Welch Ultimate C 18 column (5 μm, 2.1 mm ×50 mm) with gradient elution ( A: acetoni-trile, B:water with 0.02% formic acid).Quantification was performed using Q-TRAP MS with multiple-reaction monitoring .Six health sub-jects were divided into three groups and received single 400 mg dose of test preparation or reference preparation in three period .Plasma samples were collected at different time.The concentrations of bezafibrate were determined by LC -MS/MS. Pharmacokinetic parameters and related statistics analysis were calculated by DAS 3.2.7.Results The linear range is 50.0-1.5 ×10 4 ng? mL-1 , and had a good linear relationship ( r=0.996 9 ).The lower limit of quantitation of bezafibrate was 50 ng? mL-1 .The intra-and inter-day precisions were 1.21%-6.36%and 5.73%-7.62%, respectively.And the absolute recoveries of beza-fibrate were range from 67.56%to 77.42%.The main pharmacokinetic parameters of single oral test preparation were:Cmax was (14.52 ±4.78 )μg? mL-1 , tmax was ( 3.00 ±0.89 ) h, t1/2 was ( 2.49 ±0.84 ) h, AUC0-t was ( 52.36 ±6.23 )μg? mL-1? h, AUC0-∞ was (52.48 ±6.19 )μg? mL-1? h.According to the coefficient of variation to estimate sample size was 18 cases.Conclusion This study established a rapid , efficient and sensitive method for the analysis of the concentration of bezafibrate in plasma and also suitable for pharmacokinetic studies of bezafibrate .

BACKGROUNDMelanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS).

METHODSTumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen IV and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy.

RESULTSOf the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger omentum lesion. The pigment was shown to be positive for the Fontana-Masson and negative for Prussian blue and PAS. Immunohistochemical staining for S-100, Leu-7, HMB-45, Melan-A, and vimentin were strongly positive. Linear immunoreactions of both laminin and collagen IV was detected in all patients. Ultrastructurally, numerous elongated tumor-cell processes, duplicated basement membrane and melanosomes were observed in all developmental stages.

CONCLUSIONSHistologically, melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. Distinguishing between this tumor and malignant melanoma is of paramount importance in planning of management. Immunohistochemically, combined use of laminin and collagen IV is valuable in distinguishing melanotic schwannoma from malignant melanoma. Wide local resection and additional radiotherapy should be advocated. Further studies including cytogenetic or molecular biology are still required to better delineate melanotic schwannoma from malignant melanoma. Appropriate long-term follow-up is needed for all melanotic schwannomas.

Adult ; Aged ; Aged, 80 and over ; Child ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Aged ; Neurilemmoma ; chemistry ; mortality ; pathology ; ultrastructure ; Prognosis ; Soft Tissue Neoplasms ; chemistry ; mortality ; pathology ; ultrastructure

BACKGROUNDRecent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/Treg is present in patients with allergic asthma.

METHODSTwenty-two patients with mild asthma, 17 patients with moderate to severe asthma, and 20 healthy donors were enrolled. All patients were allergic to house dust mites. The proportion of peripheral blood CD4+CD25+ Treg cells and Th2 cells were determined by flow cytometry. The concentration of interleukin (IL)-10, transforming growth factor (TGF)-β and IL-4 in plasma was determined by enzyme linked immunosorbent assay. In these subjects, peripheral blood mononuclear cells from 17 mild asthmatic patients, 13 moderate to severe asthmatic patients and 14 healthy donors were acquired and expression of forkhead box P3 (Foxp3) and GATA-3 mRNA was detected by reverse-transcriptase polymerase chain reaction.

RESULTSCompared with healthy donors and patients with mild asthma, the percent of CD4+CD25+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. There were no significant differences in Foxp3 mRNA expression among three groups, but a downward trend seen among patients with asthma. However, the percent of Th2 cells, IL-4 levels and expression of GATA-3 mRNA was markedly higher in patients with mild and moderate to severe asthma than in the control group. The ratio of Th2/Treg and their cytokines was increased in allergic asthma, especially for moderate to severe asthma. The ratio of GATA-3/Foxp3 mRNA was also increased in allergic asthma. In patients with moderate to severe asthma, the percentage of peripheral blood Treg cells was negatively correlated to the percentage of Th2 cells and IL-4 levels.

CONCLUSIONSThe decline of CD4+CD25+ Treg cells in patients with moderate to severe asthma may play an important role in progress of the disease. Furthermore, the deficiency of CD4+CD25+ Treg cells was associated with the over-expression of Th2 response.

Asthma ; etiology ; immunology ; Cytokines ; blood ; Forkhead Transcription Factors ; genetics ; GATA3 Transcription Factor ; genetics ; Humans ; RNA, Messenger ; analysis ; T-Lymphocytes, Regulatory ; immunology ; Th2 Cells ; immunology