Objective To explore the improvement effect of rehabilitation nursing on joint swelling and pain after total knee arthroplasty.Methods According to the digital table,100 patients with total knee arthroplasty were randomly divided into observation group and control group,50 cases in each group.The control group after operation used routine nursing care,the observation group was given targeted rehabilitation nursing.They were compared with visual analogue scale (VAS),American Knee Society Score (AKSS),range of motion (ROM),length of hospital stay,joint swelling degree.Results Mter treatment,the VAS score of the observation group was lower than the control group[(2.43 ±0.51) points vs.(4.58 ± 0.81) points,t =15.882,P ＜ 0.05],AKSS scores and ROM were higher than those in the control group[(69.94 ± 14.23)points vs.(53.23± 12.91)points,(103.47 ± 14.84)° vs.(91.23 ±12.53) °,t =6.149,4.456,all P ＜ 0.05].The hospitalization time of the observation group was shorter than that of the control group[(14.23± 3.81)d vs.(17.82 ± 4.03) d,t =4.577,P ＜0.05].At 3d and 7d after operation,the swelling degree of the observation group was lower than those of the control group[(1.23 ±0.26)mm vs.(1.97 ±0.38)mm,(0.62 ± 0.21) mm vs.(1.38 ± 0.35) mm,t =11.364,13.166,all P ＜ 0.05].Conclusion The application of rehabilitation nursing after total knee joint surgery can effectively relieve joint swelling and pain,and it is worth to be popularized.

Objective:To observe the changes of vision and visual evoked potentials (VEP) in patients with Leber hereditary optic neuropathy (LHON) before and after gene therapy.Methods:A retrospective cohort study. From December 2017 to October 2018, 35 cases of 70 eyes of m11778G.A/MT-ND4 mutant LHON patients who were diagnosed in the Tongji Hospital of Huazhong University of Science and Technology and received gene therapy were included in the study. There were 30 males (87.71%) and 5 females (12.29%), with the mean age of 23.31±6.72 years. The gene therapy method was intravitreal injection of rAAV2-ND4 (recombinant adeno-associated virus carrying NADH-ubiquinone oxidoreductase subunit 4 gene) into one eye. The eye with poor visual acuity was chosen as the injection eye. If both eyes had the same visual acuity, the right eye was designated as the injection eye. Seventy eyes were divided into the injected eye group and the non-injected eye group, in which were both 35 eyes. The best corrected visual acuity (BCVA) and pattern VEP (PVEP) examinations were performed in the injected eye group and the non-injected eye group before treatment (baseline), 1, 3, and 6 months after injection. Compare the changes of BCVA and PVEP between the injected eye group and the non-injected eye group at baseline, 1 month, 3 months, and 6 months after injection. Independent sample t test, paired sample t test or two independent sample nonparametric test were performed to compare the two groups. Results:Compared with baseline, 1, 3, and 6 months after treatment, the BCVA of the injected eye group ( t=3.530, 4.962, 5.281; P=0.001, 0.000, 0.000) and the non-injected eye group ( t=3.288, 2.620, 2.252; P=0.002, 0.013, 0.031) increased, and the difference was statistically significant; there was no statistically significant difference between VEP IT ( tinjected eye group=-0.158, 1.046, -1.134; Pinjected eye group = 0.875, 0.303, 0.190; tnon-injected eye group=0.773, -0.607, -0.944; Pnon-injected eye group = 0.445, 0.548, 0.352) and VEP A ( Zinjected eye group=-0.504, -0.934, -1.065; Pinjected eye group = 0.614, 0.351, 0.287; Znon-injected eye group=-0.521, -0.115, -0.491; Pnon-injected eye group = 0.602, 0.909, 0.623). Conclusion:After gene therapy, the visual acuity of the injected and non-injected eyes of LHON patients improved; PVEP did not change significantly, and remained stable compared with baseline.

Objective To investigate the effect of atorvastatin calcium combined with sitagliptin phosphate on β2-microglobulin (β2-MG ) in peripheral blood and serum uric acid ( UA) levels in patients with type 2 diabetes.Methods A total of 78 patients with type 2 diabetes in endocrinology department from Hangzhou Xiasha Hospital were collected and randomly divided into the control group and the experimental group, with 39 cases in each group.The two groups of patients were treated by conventional treatment, life intervention, the control group were treated by metformin hydrochloride sustained-release tablet and sitagliptin phosphate, the experimental group were treated on the basis of control group with atorvastatin calcium.Both groups were treated for 3 cycles, one cycle for 7 days.The clinical curative effect,β2-MG in peripheral blood and urine, serum UA levels and adverse reactions were compared between two groups after treatment.Results After treatment, compared with control group, the clinical total effective rate in experimental group was higher (P<0.05).The serum IgG,β2-MG, urineβ2-MG and UAlb, serum UA levels were lower in two groups post-treatment compared with pre-treatment(P<0.05).Compared with control group, serum IgG, β2-MG, urine β2-MG and UAlb, serum UA levels were lower (P<0.05).There was no significant difference between two groups.Conclusion The atorvastatin calcium combined with sitagliptin phosphate has a significant efficacy in the treatment of patients with type 2 diabetes, it could down-regulate β2-MG in peripheral blood and urine and serum UA levels, improve immunity and prevent patients from cardiovascular complications.

Objective To take Ebola virus disease (EVD) as an example and analyze the capability of responding to emerging infectious diseases among medical university students in Chongqing city.Methods Medical university students of 2 094 in Chongqing were selected and investigated by cluster sampling.Questionnaire content includes social demographic information,knowledge,attitude,practice (KAP) and related factors about EVD.The variables of the respondents were described using mean and standard deviation for continuous variables and frequency distributions for categorical variables.Influencing factors were analyzed by using multiple-linear regression model.Results The average scores of KAP regarding EVD were 9.51 ±-3.97,5.93± 1.85,3.35 ±1.43,respectively.Multiple-linear regression analysis showed that the influencing factors of KAP regarding EVD were gender (x2 =0.773,P=0.000),residence (x2 =0.886,P=0.014) and health habits (x2 =0.316,P=0.008);gender (x2 =0.474,P=0.000),grade (x2 =0.118,P=0.024),residence (x2 =0.401,P=0.016) and health habits (x2 =0.307,P=0.000);gender (x2 =0.223,P=0.001),major (x2 =0.152,P=0.000) and health habits (x2 =0.231,P=0.000).Conclusion The capability of responding to emerging infectious diseases is not optimistic among medical university students.Medical universities should perform effective intervention according to the characters of different clusters.

Objective To investigate the effect of electro-acupuncture stimulation on the temperature over the body surface projection area of intestines in patients with functional constipation. Methods A total of 30 patients with functional constipation were randomly divided into a electro-acupuncture stimulation group and a false stimulation group, with 15 patients in each group. The patients in the electro-acupuncture stimulation recived electro-acupuncture at bilateral points of Tianshu, Fujie and upper Juxu for 8 weeks, a total of 28 times stimulation;the patients in the false stimulation group received false electro-acupuncture at fake bilateral points beside Tianshu, Fujie and upper Juxu for the same stimulation period. Medical infrared thermal imager was adopted to record the temperatures over the body surface projection area of ascending colon, transverse colon, descending colon, and small intestine. Results The temperature over the body surface projection area of of the ascending colon(33.35±0.96 ℃ vs. 34.62±1.15 ℃;t=2.977, P=0.010), transverse colon(33.32±0.97 ℃ vs. 34.60±1.23 ℃; t=2.839, P=0.013), descending colon(33.36±0.98 ℃ vs. 34.64±1.18 ℃; t=2.892, P=0.012), the small intestine(33.31±0.97 ℃ vs. 34.57±1.22 ℃; t=2.763, P=0.015)showed significant lower than those before the stimulation in the electro-acupuncture stimulation group. The temperature over the body surface projection area of of the ascending colon(33.74±1.25 ℃ vs. 34.52±1.64 ℃; t=1.701, P=0.111) transverse colon (33.71±1.27℃vs. 34.47±1.65℃;t=1.643, P=0.123), descending colon(33.72±1.25 ℃vs. 34.52±1.66 ℃; t=1.710, P=0.109), the small intestine(33.70±1.28 ℃ vs. 34.51±1.65 ℃; t=1.744, P=0.103)showed no significant different than those before the stimulation in the false stimulation group. Conclusion Electro-acupuncture stimulation can decrease the temperature over the body surface projection area of the ascending colon, transverse colon, descending colon, and small intestine.

Cyclin-dependent kinase 10 (CDK10) function as a tumor suppressor gene through regulating cell cycle interacting with transcription factor Ets2.Studies demonstrate that the downregulation of CDK10 expression occurs in multiple cancer types,indicating a potential application of CDK10 as a molecular diagnostic marker as well as therapeutic target.

Aim To establish phlegm and blood stasis, qi-stag-nation and blood stasis, phlegm turbid+qi-stagnation and blood stasis model in rats and to study the characteristics of animal models with different blood stasis. Methods SD rats were ran-domly divided into normal group, high fat diet group, chronic unpredictable mild stress group ( CUMS ) and high fat diet +chronic unpredictable mild stress group. Different states of blood stasis rat models were established by corresponding factors for 6 weeks. Indexes of weight, open field behavior, serum lipids and corticosterone were monitored dynamically at the 2 nd, 4 th, 6 th weeks. At the end of the experiment(6th week), the heart func-tion was detected by small animal ultrasound and the left ventric-ular intubation. The blood rheology indexes were detected by the viscosity tester and red blood cell deformation/aggregation test instrument. Results Compared with the normal group, blood stasis could be induced by high fat diet and chronic unpredicta-ble mild stress, introducing the influence of different degree on animal behavior, blood lipids, heart function and blood viscosi-ty. When the two factors were superimposed, the changes of the indexes about blood stasis were the most significant. Perform-ance as: compared with normal control group, a significant re-duction was observed in body weight ( P < 0. 01 ); horizontal movement, vertical movement and movement time were reduced (P<0. 01 or P<0. 05) at the 2 nd week;at the 2 nd and 4 th week, serum corticosterone was increased ( P <0. 01 or P <0. 05) as well as TG at the 4 th and 6 th week (P<0. 01); at the 6 th week, velocity of blood was slowed down ( P<0. 01 );left ventricular anterior wall and posterior wall thickness at end-systolic was increased ( P<0. 01 or P<0. 05 ); left ventricular diastolic index was increased ( P<0. 01 ); the maximum rate of myocardial contraction was decreased ( P < 0. 05 ); the whole blood viscosity was increased ( P<0. 01 ) . Conclusions Blood stasis could be formed by high fat diet and chronic unpredictable mild stress, which has different characteristics. When the two factors are superimposed, the abnormal behavior, blood viscosi-ty, heart function, blood lipid and other indexes of the animal could obviously appear, which can provide the basis for the stud-y of blood stasis syndrome and related drugs.

Objective To systematically review the effectiveness and safety of statins for chronic obstructive pulmonary diseases (COPD) combining with pulmonary hypertension (PH).Methods The electronic searches in databases of PubMed,EMbase,the Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang Data were conducted from the date of their establishment to January 2016 and the references of the include studies were also retrieved for collecting randomized controlled trials (RCTs) or quasi-RCTs on statins treating COPD combining with PH.Two researchers independenlty screened the literature according to the inclusion and exclusion criteria,extracted the data,assessed the quality of the included studies by adopting the Cochrane collaboration' s tool for assessing risk of bias,and performed Meta-analysis by using RevMan 5.3 software.Results A total of 24 studies involving 1 587 cases were included.The results of Meta-analysis showed that:compared with the control group,simvastatin significantly improved FEV1 [MD =0.23,95％ CI:0.16-0.31,P ＜ 0.000 01],FEV1 ％ [MD =6.73,95％ CI:1.34-12.12,P =0.01],FVC [MD =0.39,95％ CI:0.34-0.45,P ＜ 0.000 01],6 minutes walk distance (6MWD)· [MD=59.09,95％CI:54.24-63.93,P ＜0.000 01] and decreased mPAP [MD=6.73,95％ CI:1.34-12.12,P =0.01],SPAP [MD =-4.53,95 ％ CI =-8.87--0.19,P =0.04].Atorvastatin significantly improved FEV1 [MD =6.22,95 ％ CI:2.51-9.93,P =0.001] and 6 MWD [MD =24.10,95 ％ CI:12.98-35.23,P ＜ 0.000 1] and decreased sPAP [MD =-6.44,95％CI:-7.95--4.93,P＜0.00001] andmPAP [MD=-3.51,95％CI:-5.81--1.22,P=0.003].But no significant difference was found in the improvement of FEV1,FVC or FEV1/FVC.Fluvastatin significantly decreased sPAP [MD=-5.89,95％ CI:-6.99--4.79,P ＜0.000 01].There was a significant decrease in the Borg dyspnoea score in statins group [MD =-3.37,95％ CI:-4.61--2.14,P ＜ 0.000 01] as compared with the controls.In addition,the incidence of adverse drug reactions (ADRs) was similar between statins and the control group.Conclusion Current evidence suggests that statins may decrease pulmonary hypertension in patients with COPD combining with PH.However,high-quality clinical trials with large sample size are needed to verify whether the improvement of pulmonary function,6MWD and Borg dyspnoea score are the class effect or the incidence of ADRs is disparate among different statins.

Background and purpose:The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial has been described as practice-changing of sentinel lymph node (SLN) positive breast cancers. The goal of this study was to determine the exportability of the criteria deifned by Z0011 trial for selecting patients who are eligible for avoiding axillary lymph node dissection (ALND) after a positive sentinel lymph node biopsy (SLNB) result in China.Methods:We collected 194 breast cancer patients with positive SLNs and classiifed them into two groups according to Z0011 criteria. One group was consisted of patients who were eligible for omitting ALND and with SLNB only. The other one was ALND group. Then the patients of SLNB group were compared with cohort included in the Z0011 trial and the ALND group of this study separately.Results:Seventy-seven patients were potentially eligible for omitting ALND and 117 patients were still needed to have ALND. Compared with Z0011 cohort, the SLNB group in this research had signiifcantly more T1 stage and ER positive tumors (P<0.05). More patients in SLNB group had positive LNs with the number less than 3 and negative NSLNs (P<0.05). The ALND group had more T2 and T3 stage tumors than the SLNB group but the difference was not signiifcantly. The number of positive LNs in ALND group was higher than the SLNB group signiifcantly (P<0.05). More patients in the ALND group had positive non-sentinel lymph node (NSLN) than the SLNB group and the difference was also signiifcantly (P<0.05).Conclusion:Applied to the SLN positive patients in this study, Z0011 criteria could make patients with better prognosis and lower risk than Z0011 cohort be selected and let these patients avoiding ALND more safely.

Objective To develop a new method for establishing a temperature gradient field in the microchannel on a glass-polydimethylsiloxane ( PDMS ) microfluidic chip and to verify its applicability in the study of cellular thermal biological effect.Methods The establishment and control of the temperature gradient field in the microchannel were implemented by a peripheral indium tin oxide ( ITO) heater and a heating micro-wire embedded in the PDMS chip.The temperature gradient field established in the microchannel was represented by the finite element numerical analysis and temperature-dependent fluorescent dye rhodamine B.Finally, the thermal biological effect, which used cell survival rate of human prostate cancer cells T24 as an indicator, was investigated in the microchannel.Results The results of finite element numerical analysis proved that this method established a temperature gradient field along the length of the microchannel successfully.The distribution range of the temperature gradient field was controlled by the ITO heater, while the gradient of the temperature gradient field was controlled by the heating micro-wire.The measurement result of rhodamine B was identical with the result of the finite element numerical analysis.The thermal biological effect of T24 tumor cell research showed that the cell survival rate decreased with the rise of the regional temperature in the microchannel.Conclusion The method developed in this paper for establishing a temperature gradient field in the microchannel on a glass-PDMS microfluidic chip is simple and easy to implement, and it can be used for parallel study of the cellular thermal biological effect on the microfluidic chip in the future.