Objective Background:MicroRNAs (miRNAs) are naturally occurring small non-coding RNAs,play important roles in cancer initiation and progression.Decreases in miRNAs levels are observed in human cancers,indicating that miRNAs may function intrinsically in tumor suppression.However,the underline mechanisms of miRNA function are little known.Methods MiR-34b in non-small cell lung cancer (NSCLC) tissues was detected using quantitative Real-Time PCR.The relations between miR-34b expression level and clinical pathological parameters were assessed.For in vitro studies,lung cancer cells were transfected with double stranded synthetic miRNA mimics and scrambled controls.Immunohistochemistry technology was explored to validate the related downstream proteins of miR-34b.Results Expression of miR-34b was lower in NSCLC tissues than that in pericarcinous tissues of lung cancer.Additionally,the Spearman correlation test showed lower miR-34b expression was correlated with higher lymph node metastasis (P =0.031).In vitro gain-of-function experiments indicated that miR-34b suppressed cell proliferation by inducing cell apoptosis.IHC results showed relations between lower miR-34b and over-expression of phospho-Met (P =0.012).Conclusion MiR-34b down-regulates Met,following with subsequent changes of downstream p53 and Mdm2,and inversely p53 up-regulates miR-34b in a feedback loop.MiR-34b plays profound roles in progression of NSCLC by inducing apoptosis and decreasing lymph node metastasis.

BACKGROUND: The complicated localization of intramedullary nails and osteotomy more dependent on surgeons' experience limit the application of conventional total knee arthroplasty (TKA). The occurrence of three-dimensional (3D) printing technology can achieve precise localization and osteotomy in TKA.OBJECTIVE: To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum.METHODS: Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups (n=17 per group) in accordance with the random number table. One group was treated with TKA with 3D printing guild plate (3D printing group), while the other group received the conventional TKA (conventional group).The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups.RESULTS AND CONCLUSION: (1) The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively (P=0.744). (2) There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively (P= 0.532). (3) The postoperative lower limb mechanical alignment showed no significant difference between two groups (t=0.218, P=0.632).(4) The operation time in the 3D printing group was significantly shorter than that in the conventional group (P=0.000). (5) The blood loss in the 3D printing group was significantly less than that in the conventional group (P=0.000). (6) Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time,reduces the blood loss, and achieves precise osteotomy, which is available for the elderly with poor basic condition, and weak tolerance of surgery.

Osteoporotic vertebral compression fracture (OVCF) is the most common complication of spinal osteoporosis, mostly occurring in thoracolumbar segment, which can cause acute and chronic pain at the fracture site and loss of vertebral height, and can lead to progressive kyphosis. For kyphosis caused by old OVCF, open surgery such as anterior or posterior decompression and fusion, internal fixation and osteotomy can improve local sequence and achieve satisfactory kyphotic correction which is difficult to complete in percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), and reconstruct the sagittal balance. Due to the older age of OVCF patients, some of them have poor general conditions. In addition, osteoporosis leads to increased vertebral fragility, which increases the risk of surgery and postoperative internal fixation failure. The anterior approach presents some problems including a complex approach and poor mechanical stability. At present, most studies focus on posterior surgery. Due to the limitation of kyphosis correction by decompression and fixation alone, osteotomy is often required to correct kyphosis. In cases of old OVCF with kyphosis, the screw holding capability decreases due to the decrease of bone mineral density. Additionally, once the screw loosens, the orthopedic effect is inevitably affected. To enhance pedicle screws, most studies have utilized bone cement to increase the axial pullout force of the vertebral body and improve screw stability. The selection from different osteotomy methods is a critical determinant in achieving favorable surgical outcomes for patients.

Objective:To explore the effect of the operation process query system and the psychological impact on the surgical patient's family members.Methods:From April to October 2019, 198 family members of patients whose operation time> 1 hour were selected from the Shanghai East Hospital, Tongji University. The patients were divided into a control group and an observation group according to the order of operation, with 99 cases in each group. Both groups implemented preoperative visits, preoperative assessments, and preoperative education. The control group performed routine nursing of Operating Room and did not specifically inform family members of the information about the operation process during the operation. The family members of the observation group could view information about the operation process in the operation progress query system. The State-Trait Anxiety Inventory (S-AI) was used to assess the anxiety of the family members of the two groups of patients, and we compared the changes of pulse, respiration and blood pressure before and during the operation of the two groups of family members, and compared the satisfaction of the family members of the two groups after the operation.Results:The anxiety scores and vital signs of the family members of the two groups of patients during the operation were higher than those before the operation. The family members of the observation group had an intraoperative anxiety score of (49.01±7.91) , pulse (92.97±8.76) times/min, respiration (20.13±1.64) times/min, systolic blood pressure (122.06±11.69) mmHg, diastolic blood pressure (82.86±6.45) mmHg, all lower than those of the control group, the differences were statistically significant ( t=20.494, 6.749, 26.784, 4.387, 8.139; P<0.01) . The total satisfaction of the family members of the observation group after the operation was 95.96% (95/99) , and that of the control group was 63.64% (63/99) , and the difference was statistically significant (χ 2=34.932, P<0.01) . Conclusions:The application of the operation query system can effectively alleviate the psychological anxiety of the family members of the surgical patients and improve the satisfaction of the family members of the patients with the operation.

Objective:To construct a training program for specialist nurse in Hybrid Operation Room based on the Context, Input, Process and Product (CIPP) model, and to explore its effect.Methods:Based on the CIPP model, a training program for specialist nurse in Hybrid Operation Room was constructed. From March 2020 to March 2021, 100 Operating Room nurses from Shanghai East Hospital affiliated to Tongji University were selected by convenience sampling and divided into the control group and the observation group, with 50 cased in each group. The control group adopted the conventional training for specialist nurses, while the observation group adopted the CIPP model training program for specialist nurses in Hybrid Operation Room. The training effect of the nurses in the Operating Room was compared between the two groups.Results:After the training, the scores of nurses in the observation group were higher than those in the control group in terms of specialist theory and operational skills, and the differences were statistically significant ( P<0.05) . After the training, the preoperative operation standard, intraoperative operation standard rate , operation standardization rate of surgical instruments and operation coordination of nurses in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The training program for specialist nurses in hybrid surgery based on the CIPP model can improve the operational skills of nurses in the Hybrid Operation Room, and is conducive to improving the quality of Operating Room management.

OBJECTIVE: To determine the incidence and risk factors associated with acute kidney injury (AKI) in patients after cardiac surgery with extracorporeal circulation. METHODS: A retrospective case control study was done in patients who underwent cardiac surgery from 2003 to 2007 in Second Xiangya Hospital, with 340 patients in an AKI group and the other 4 760 patients without AKI as a control group. All variables were analyzed by univariate analysis, Mann-Whitney U test and logistic regression. RESULTS: AKI occurred in the 340 patients (6.7% incidence). Univariate analysis revealed that age, preoperative serum creatinine, preoperative ejection fraction (EF), preoperative beta2-microglobulin, preoperative blood albumin, preoperative blood uric acid, intraoperative cardiopulmonary bypass time, intraoperative aortic cross-clamp time, and dosage of mannitol were significantly related to AKI following cardiac surgery with extracorporeal circulation. Logistic multivariate regression analysis showed that preoperative serum creatinine (P<0.001), preoperative ejection fraction (EF) (P<0.001), preoperative beta2-microglobulin (P=0.002), preoperative blood uric acid (P=0.015), intraoperative cardiopulmonary bypass time (P<0.001), and intraoperative aortic cross-clamp time (P<0.001) were independent risk factors for AKI. CONCLUSION The incidence of AKI after cardiac surgery with extracorporeal circulation is closely related with a variety of perioperative risk factors. Our data suggest that patients planning to accept cardiac surgery with extracorporeal circulation should be more comprehensively assessed and monitored, thereby preventing the occurrence of AKI.
Acute Kidney Injury ; epidemiology ; etiology ; Adolescent ; Adult ; Cardiac Surgical Procedures ; adverse effects ; Cardiopulmonary Bypass ; adverse effects ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Young Adult