BACKGROUND: Nowadays stem cells have been isolated successfully from the epithelial tissue of human and rodents such as skin, hair follicle, cornea, oral mucous, intestinal mucosa dental epithelial cells, and salivary glands by the Chinese or foreign researchers. But according to the vaginal mucosa stem cells (VMSCs), it is not known in the field of isolation and application.OBJECTIVE: To find out the suitable method of isolation, identification, and culture of human VMSCs.DESIGN: Observational basic study. SETTING: Department of Gynaecology and Obstetrics, the Third Affiliated Hospital of Guangzhou Medical College. MATERIALS: This study was performed in the Zhongshan Ophthalmology Center of Zhongshan Medical College from October 2004 to August 2005. Two-week gestation mice were provided by the Experimental Animal Center of Guangzhou University of Chinese Medicine. The sterile human vaginal mucosa was collected from five patients (25-38 years old) after the plastic operation of vagina from the 3rd Affiliated Hospital of Guangzhou Medical College. METHODS: Vaginal mucosa cells could be harvested from human vagina mucosa treated with trypsin-collagenase digesting. The VMSCs were selected by adhesion to type Ⅳ collagen for 20 minutes. The cell cycles of the VMSCs and primary human vaginal mucosa cells were analyzed by flow cytometry. VMSCs were cultured in vitro with 4 different media, including feeder layer cells plus epidermal total culture media, feeder layer cells plus DMEM/F12 (3:1), epidermal total culture media and DMEM/F12 (3:1). At the 12th day, their colony forming efficiency (CFE), CK19 and CK10 positive rates were compared. Then VMSCs were continuously cultured and passaged till they were apoptosis.MAIN OUTCOME MEASURES: ① Positive rate of CK19 and CK10 and G0/G1 proportion; ② Positive rate of CK19 and CK10, the colony forming efficiency (CFE) and the times be passaged when primary VMSCs were cultured in different media after 12 days. RESULTS: The cells at the G0-G1 phase cell cycle, CK19 and CK10 positive rates between the VMSCs and primary human vaginal mucosa cells were statistical different (P < 0.05). When cultured at 12th day, the VMSCs cultured with feeder layer and epidermal total culture media had the highest CFE and CK19 positive rate and lowest CK10 positive rate. They could be passaged over 15 times in vitro. CONCLUSION: It is an effective way that select VMSCs by adhesion to type Ⅳ collagen for 20 minutes. In this research, culturing VMSCs in vitro with feeder layer and epidermal total culture media was the best way to keep VMSC characteristics.

Objective To compare the efficacy of gradient and swim-up semen preparation techniques on pregnancy rates in couples undergoing intrauterine insemination (IUI) cycles with human menopausal gonadotropin (HMG) stimulation. Methods Five hundred and seventy one cycles were devided into the swim up or the gradient technique groups for sperm preperation. The clinical pregnancy rates per cycle were evaluated. Results The clinical pregnancy rates per cycle were significantly higher in the gradient group (17.8%) than that in the swim up group (11.4%)(P < 0.05). In the subgroup of unexplained subfertile couples, the gradient group also revealed significantly higher clinical pregnancy rates per cycle (33.7%) than that in the swim up group (20.3%)(P<0.05). In couples with mild male factor subfertility, the gradient group also revealed significantly higher clinical pregnancy rates per cycle (11.6%) than that in the swim up group (7.6%)(P < 0.05). Conclusion The gradient technique significantly improves clinical outcome in IUI cycles of unexplained subfertile and male subfertile couples.

Objective To investigate the fatigue experience of the community-dwelling frail elderly to establish the conceptual model.Methods Grounded theory was adopted.With MAXQDA v10.4.15.1for 3 levels coding,the conceptual model of fatigue experience of community-dwelling frail elderly people was structured through constant comparison and in-depth analysis.Results Multi-response,selfmanagement,safe and belonging,hitting rock bottom,accepting and transferring formed the conceptual model.Conclusions Based on the conceptual model,nurses should pay more attention to concern about the fatigue experience of community-dwelling frail elderly people,and probe different assessment methods to enrich comprehensive geriatric assessment (CGA),then improve the community health service level and the quality of elderly people's life.

Tumor-associated macrophage (TAM) is a macrophage infiltrating around tumor cells, which can be divided into two categories including classical activated macrophages (M1) and alternately activated macrophages (M2). On the whole, it shows the phenotype of M2 macrophages that promote immune escape of tumor cells. With the in-depth study of the immune function of the body, the studies have indicated that TAM is highly malleable and can be transformed into each other with the change of tumor microenvironment. TAM plays a very important role in tumor occurrence, development, invasion and metastasis, and its classification and quantity may also be used as an index to judge the prognosis of tumors. Therefore, TAM is a feasible potential target for the treatment of cancer. This paper reviews the role of TAM in tumorigenesis and development.

Objective To explore the lowest effective dosage of mifepristone combined with misoprostol in terminating ultra-early pregnancy.Methods All the cases of ultra-early pregnancy classified by amenorrhea days,β-hCG and vaginal B-ultrasonic were randomly divided into two groups.One hundred cases in G1 group (minimized dosage) were orally administered 25 mg mifepristone once a day for 2 days and combined with 200 μg misoprostol 48 hours later,while 150 mg mifepristone combined with 600 μg misoprostol 48 hours later were given to 100 cases in G2 group (normal dosage).All cases were observed for 6 hours after taking misoprostol and returned for assessment three days later.Results None missing.Expulsion of conceptus:G1 and G2 group were 22 (22.0％,22/100) and 25 (25.0％,25/100;P ＞ 0.05).Failure rate:cases with incomplete abortion were 1 (1.0％,1/100) and 2 (2.0％,2/100) in G1 and G2 group,hospitalization for suspected ectopic pregnancies both was 1 (1.0％).Bleeding:bleeding cases during the administration of mifepristone in G1 and G2 group were 71 (71.0％,71/100) and 78 (78.0％,78/100; P＞0.05); the mcan bleeding time were (5.3 ± 1.4) days and (6.0± 1.5) days (P ＜0.01).Other side effects:in G1 group,majority showed light nausea (7.0％,7/100) and light abdominal pain (20.0％,20/100).Menses recovery:99 (99.0％,99/100) for G1 group and 98 (98.0％,98/100) for G2 group to recovery on scheduled time.Satisfactions:both were 99 (99.0％,99/100).Except mean bleeding days and side-effects,the differences above showed no significance (P ＞ 0.05).Conclusion It is safe and effective treatment with the lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancies.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups: control group (n=56) treated with conventional therapy, and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells (WBC) counts, prothrombin time (PT), serum creatinine (SCr), alanine aminotransferase (ALT), serum albumin and PaO(2) were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced (P<0.05), but the level of serum albumin was significantly increased (P<0.05) at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 (P<0.01) after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased (P<0.01). The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

ObjectiveTo analyze hospitalized death related factors in elderly patients with nonST-segment elevation myocardial infarction (NSTEMI). MethodsThree hundred and two patients (≥65 years old) with NSTEMI were included. Thirty-two patients of them died in hospital (death group). Their clinical data were retrospectively analyzed and correlated factors for in-hospital death were evaluated. ResultsCompared with survival group, patients in death group were more likely to have 3 or more chronic diseases,heart function killip grades Ⅲ- Ⅳ, heart rate＞ 100/min and peripheral blood WBC count＞10X 10＜'9＞/L on admission (all P＜:0.05). There was no significant difference in fasting plasma glucose level and serum creatinine on admission between the two groups (both P:＞0.05). But after glomerular filtration rate(eGFR) were estimated by the modified abbreviated MDRD equations based on the Chinese CKD patients, patients in death group were more likely to be with renal dysfunction and pulmonary infection (both P＜0.01 ). Multiple logistic regression analysis showed that heart function killip grades Ⅲ-Ⅳ, renal dysfunction evaluated by eGFR, pulmonary infection on admission were the independent predictors for in-hospital death in elderly patients with NSTEMI. ConclusionsCoexistence of 3 or more chronic diseases is a related factor of death and heart function killip grades Ⅲ-Ⅳ, renal dysfunction evaluated by eGFR and pulmonary infection are the independent predictors for in-hospital death in elderly patients with NSTEMI.

The study of pulse wave, including its quantitative analysis and propagation, is one of the hot topics in the fields of clinical medicine, such as how to detect cardiovascular diseases and make early diagnosis without harm. In this paper are discussed a new type of automatic cardiovascular diagnosis method and the corresponding test instrument. The cardiovascular system parameters can be achieved through the wave changes, related data processing and analyzing. This system includes piezo-film transducer, signal amplifier, data collecting and data analyzing equipment. Various pulse diagrams can be shown in omnidirectional and multifunctional ways. The measurement error can be reduced effectively by introducing Mini-wave analysis in the design of software. The research indicates that combination of this equipment with the traditional Chinese medicine will provide wide practical application.
Algorithms ; Animals ; Cardiovascular Diseases ; diagnosis ; Diagnosis, Computer-Assisted ; instrumentation ; methods ; Dogs ; Equipment Design ; Pulse ; instrumentation ; methods ; Software Design

Objective To search,evaluate,and integrate the best evidence on the safety and accuracy of peripherally inserted central catheter(PICC)tip positioning in intracardiac ECG so as to provide evidence-based support for clinical practice.Methods Following the"6S"evidence resource pyramid model,evidence was systematically searched from top to bottom across databases,such as BMJ Best Practice,UpToDate,National Institute for Health and Care Excellence,Guidelines International Network,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,JBI(Joanna Briggs Institute)Evidence-Based Healthcare Database,PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,SinoMed and VIP Database.The search period was from the inception the database to 1st February,2024.Two researchers independently evaluated the quality of the literature and extracted evidence that met the criteria.Results A total of 12 articles were retrieved including 2 guidelines,1 group standard,1 expert consensus,1 Meta-analysis,1 systematic review,3 randomised controlled trials,1 diagnostic study and 2 cohort studies.They covered 6 themes such as pre-catheterisation assessment and preparation,the best tip position and waveform for adults,the best tip position and waveform for neonates,the best tip position and waveform for patients with atrial fibrillation,maintaining waveform stability during catheterisation and relevant information recording during the catheterisation process.A total of 22 pieces of evidence were summarised from the documents.Conclusion This study summarises the best evidence in the safety and accuracy of PICC tip positioning techniques of intracardiac ECG,which can provide a basis for nursing staff to practice evidence-based nursing.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated.A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups:control group (n=56) treated with conventional therapy,and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L.White blood cells (WBC) counts,prothrombin time (PT),serum creatinine (SCr),alanine aminotransferase (ALT),serum albumin and PaO2 were measured before and at the day 1,3,5,7 and 14 after treatment.The incidence of gastrointestinal dysfunction,the incidence of MODS,hospital stay and the mortality were also observed and compared.After intensive insulin therapy,the WBC counts,SCr,ALT and PT were significantly reduced (P＜0.05),but the level of serum albumin was significantly increased (P＜0.05) at the day 3,5,7 and 14.In the meantime,the PaO2 was significantly elevated at the day 3,5 and 7 (P＜0.01) after intensive insulin therapy.The incidence of gastrointestinal dysfunction,the incidence of MODS,the length of hospital stay and the mortality were markedly decreased (P＜0.01).The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.