Objective To explore the clinical application value of combined detection of serum brain natriuretic peptide (BNP),homocysteine(HCY) and blood lipids in the patients with heart failure.Methods The levels of serum BNP,HCY,TC,TG,HDL-C,LDL-C,ApoA,ApoB and Lpa were detected in 100 patients with heart failure (observation group) and contemporaneous 100 persons (control group) undergoing healthy physical examination.Then the comparative analysis was performed.Results Compared with the control group,the BNP and HCY levels in the observation group were significantly increased(P＜0.05);among 7 indicators of the blood lipid,the Lpa level in the observation group was increased compared with the control group,while the TC,HDL-C and LDL-C levels were significantly decreased(P＜0.05),and the TG,ApoA and ApoB levels had no statistical differences between the two groups(P＞0.05).Conclusion Serum BNP,HCY,TC,HDL-C,LDL-C and Lpa levels have close correlation with heart failure,especially the combined detection of BNP,HCY and Lpa,which has predictive and diagnostic value in heart failure and is worthy of clinical popularization and application.

OBJECTIVETo investigate the roles of phosphatidylinositol 3 kinase regulatory subunit alpha (PIK3R1）gene in the development of hepatocellular carcinoma （HCC）.

METHODSSurgical specimens of liver cancer and corresponding pericancerous liver tissue were collected from 20 patients with hepatocellular carcinoma. Expression of p85α, encoded by PIK3R1, in HCC tissue specimens was detected by Western blotting and immunohistochemistry. HCC HepG2 cells were transfected with PIK3R1 siRNA or PIK3R1-cDNA. The expression of PIK3R1 in transfected HepG2 cells or control cells were detected by real-time PCR. Cell proliferation was evaluated by MTT, colony formation assays and flow cytometry respectively. The expression of PI3K/AKT pathway-related proteins were detected by Western blotting.

RESULTSThe expression of p85α in liver tissue was higher than that in pericancerous tissues (1.27±0.58 vs 0.99±0.47，t=-3.25，P<0.05）. The expression of PIK3R1 was decreased by 0.19±0.03 fold in PIK3R1siRNA-transfected HepG2 cells(t=46.77，P<0.05)，and increased by 32.36±3.33 fold in PIK3R1 cDNA -transfected cells（t=-16.31， P<0.05）. MTT result showed that PIK3R1 siRNA inhibited growth of HepG2 cells （0.611±0.072 vs 0.807±0.059，t=3.65，P<0.05），while PIK3R1 cDNA increased the cell growth（0.937±0.060 vs 0.693±0.065，t=-4.78，P<0.05）. PIK3R1 siRNA transfected cells presented lower colony-forming efficiency than control group（3.8%±0.84% vs 15.0%±2.3%，t=7.92，P<0.05），while PIK3R1 cDNA transfected cells had higher colony-forming efficiency than control group (23.6%±3.4% vs 12.0%±1.5%，t=-5.40，P<0.05）. PIK3R1 siRNA reduced the ratio of S phase cells（13.9%±0.015% vs 32.9%±0.07%，t=45.97，P<0.01, while PIK3R1 cDNA increased S phase cells（56.33%±0.024% vs 31.94%±0.042%，t=-8.73，P<0.01）. PIK3R1 increased the level of p-AKT and decreased p53 level. CONCLUSION：p85α is highly expressed in HCC，and PIK3R1 gene may promote proliferation of HepG2 cells by activating PI3K/AKT pathway.

Carcinoma, Hepatocellular ; genetics ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Hep G2 Cells ; Humans ; Liver Neoplasms ; genetics ; Phosphatidylinositol 3-Kinases ; genetics ; Proteins ; RNA, Small Interfering ; Transfection

Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery* ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Reconstructive Surgical Procedures ; Robotics

OBJECTIVE: To compare the femoral and tibial tunnel positions of anterior cruciate ligament reconstruction using the modified transtibial (MTT) technique and anteromedial (AM) portal technique. METHODS: Between January 2017 and September 2020, 78 patients with anterior cruciate ligament rupture underwent single-bundle reconstruction with the modified transtibial technique in 39 cases (group MTT) and through anteromedial approach in 39 cases (group AM). There were 25 males and 14 females in group MTT, with an average age of (37.0±2.3) years old; 27 males and 12 females in group AM, with an average age of (37.5±2.2) years old. CT scan of the affected knee was conducted one week after the surgery to measure and compare the femoral tunnels positioning (Fx, Fy), tibial tunnels positioning in the frontal plane(Tx1), tibial tunnels positioning in the sagittal plane (Ty1), and tibial tunnels positioning in the axial plane (Tx2, Ty2) in patients undergoing anterior cruciate ligament reconstruction through Mimics software. RESULTS: Three-dimensional CT reconstruction after the surgery showed that the average Fx and Fy were(25.2±2.1)% and (34.9±3.0)% respectively and the Tx1 and Ty1 were (45.5±3.3)% and (44.7± 3.0)% respectively, while the Tx2 and Ty2 were (47.0±3.0)% and (39.9±4.2)% respectively in group MTT. In group AM, the average Fx and Fy were (26.0±2.0)% and (36.1±3.9)% respectively and the Tx1 and Ty1 were (46.5±3.1)% and (45.6± 3.1)% respectively, while the Tx2 and Ty2 were (47.4±2.5)% and (39.6±3.9)% respectively. There were no statistically significant differences in the femoral and tibial tunnels between the two groups ( CONCLUSION Both the MTT and AM technique can achieve good anatomical positioning of the femoral and tibial tunnels, without significant differences in the positioning of the bone tunnels.
Adult ; Anterior Cruciate Ligament/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Anterior Cruciate Ligament Reconstruction ; Female ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Male ; Software ; Tibia/surgery* ; Tomography, X-Ray Computed

Objective To explore the application value of rehabilitation nursing model based on early intervention in high-risk infants with cerebral palsy.Methods A total of 112 high-risk infants with cerebral palsy were selected from neonatal intensive care unit of Jiaxing Maternity and Child Health Care Hospital from January to December 2022.According to the parents'wishes,they were divided into observation group and control group,56 cases in each group.The control group was adopted routine nursing mode,and the observation group was given rehabilitation nursing mode based on early intervention on the basis of routine nursing.At correction of 1 month and 3 months,general movements quality assessment method was used to evaluate central nervous system development of two groups.Results At correction of 1 month and 3 months,the normal rate of infants in observation group was significantly higher than that in control group(P<0.05).Conclusion The rehabilitation nursing model based on early intervention can promote the neurodevelopment of high-risk infants with cerebral palsy to a certain extent,and can be popularized in early clinical nursing.

Objective: To observe the feasibility and clinical curative effect of anatomical reduction and fixation of lesser trochanter through posterior-lateral approach for the treatment of comminuted femoral intertrochanteric fractures in elderly patients. Methods: A total of 19 cases with comminuted femoral intertrochanteric fracture, aged 60 to 84 years were enrolled in this study.According to Evans-Jensen classification, 13 cases had type Ⅱ B and 6 cases had type Ⅲ femoral fracture.Through the posterior-lateral approach, the lesser trochanter was fully exposed, reduced and fixed by screw.The proximal and distal femur were well fixed with dynamic hip screw(DHS)or proximal femoral locking plate(PFLP). The lesser trochanter reduction was observed by intraoperative vision and postoperative X-ray.The function evaluation after hip surgery was performed by using Sanders hip function score. Results: All 19 patients obtained the anatomic reattachment in the lesser trochanter.All patients were followed up for an average of 18 months.After treatment, the Sanders hip function score were excellent in 7 patients(36.8%), fine in 12 cases(63.2%). And curative efficacy was good in all cases(100%). There was no significant difference in the curative effect between patients with different classification and gender. Conclusions Through the posterior-lateral approach, the surrounding structures of the lesser trochanter can be fully exposed, and the lesser trochanter can be anatomically repositioned.The posterior-lateral approach to anatomical reduction and fixation of lesser trochanter is an effective and feasible method for the treatment of comminuted intertrochanteric fracture in the elderly.

Objective To evaluate the effectiveness and safety of inferior oblique transposition combined with medial and lateral rectus surgery in the treatment of inferior oblique hyperfunction combined with V-type strabismus.Methods Thirty-nine patients with inferior oblique hyperfunction combined with V-type strabismus admitted to Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from November 2020 to September 2021 were selected as study objects,and were divided into combined operation group(n=28)and multiple operation group(n=11)according to different surgical programs.The visual acuity,eye position,cure rate of V sign,correction rate of inferior oblique hyperfunction,oculocardiac reflex,oculogastric reflex and complications were compared between two groups.Results One month after surgery,patients of two groups recovered the first eye position,and there were no statistical significances in the number of V sign cured and the number of inferior oblique hyperfunction corrected(P>0.05).Visual acuity returned to preoperative level in both groups.There were no significant differences in oculocardiac reflex and oculogastric reflex between two groups(P>0.05).There were no inflammatory reaction,massive subconjunctival hemorrhage,subcutaneous hematoma of eyelid,retrobulbar hemorrhage and other complications in two groups.Conclusion The effect of inferior oblique transposition combined with medial and lateral rectus surgery in the treatment of inferior oblique hyperfunction combined with V-type strabismus is not inferior to that of conventional divided operation,but it can reduce the number of operations and avoid the pain caused by the second operation,which is worthy of clinical application.

Objective To evaluate the role of transarterial chemoembolization (TACE) as an adjuvant therapy in patients with hepatocellular carcinoma (HCC) treated with hepatectomy. Methods Clinical data of 386 consecutive patients who underwent hepatectomy for HCC were analyzed retrospectively.Of the 386 patients, 156 patients did not undergo TACE served as controls (non-TACE group), the remaining 230 patients underwent TACE (TACE group) preoperatively (n=71), postoperatively (n=86), or both (n =73). For the purpose of comparison, patients who did not undergo preoperative TACE were assigned to group A (n=242), and those patients who underwent preoperative TACE were assigned to group B (n =144). Patients cumulative survival rates were calculated by survival table and analyzed using Kaplan-Meier survival curves. Results There were significantly higher complete necrosis rates in group B (18/144) than those in group A (0/242) ( P ＜ 0.01). The difference between the survival rate of patients with complete necrosis and those with incomplete necrosis was statistically significant (P＜0.01).The 1-,3-,5-and 10-year survival rates were 90.4%(66/73),72.9%(42/73),51.9%(22/73) and 25.4%(2/73) in combined TACE group, 74.0% (50/71) ,46.2%(28/71) ,27.3%(5/71) and 0(0/71) in preoperative TACE group, 88. 0% (73/86) ,59. 6% (39/86) ,36. 7% (11/86) and 0(0/86) in postoperative TACE group, and 75. 8% (110/156), 63.4% (48/156), 31.0% (13/156) and 23.9% (10/156) in non-TACE group,respectively. Combined TACE group got a significantly higher survival rate compared with non-TACE group or preoperative TACE group or postoperative TACE group (P＜0.05). The survival rates in either preoperative or postoperative TACE group were not significantly better than those in non-TACE group (P＞0.05).Conclusions As an adjuvant treatment, combined pre-and post-operative TACE can increase survival rate in patients with surgically resectable HCC. No significant benefit for patient's long term survival when either preoperative or postoperative TACE was performed in addition to surgery.

Objective To investigate the relationship between pelvic asymmetry and Crowe classification of unilateral developmental dysplasia of the hip in adults. Methods According to the inclusion criteria, 100 cases of unilateral DDH in adults were collected, including 78 females and 22 males, with an average age of 56.3 years old (range, 21-79 years). In terms of Crowe classification, there were 30 cases of Crowe typeⅠ, 24 cases of Crowe typeⅡ, 23 cases of Crowe typeⅢ, and 23 cases of CroweⅣ. The normal?side and affected?side pelvic vertical height (the distance from the highest point of the ischial tuberosity to the iliac crest peak) were measured via the radiogram of anteroposterior pelvis. Furthermore, we compared the affected?side pelvic vertical height with the normal?side and analyzed the relationship between Crowe classification and the difference in pelvic verti?cal height. Results The average pelvic vertical height was 23.38±1.46 cm in the normal?side and 22.41±1.38 cm in the affected?side. The average D?value of pelvic vertical height between two sides is 0.98 ± 0.76 cm. From Crowe typeⅠto Ⅳ, the average heights of the normal?side were 22.89±1.09 cm, 23.23±2.07 cm, 23.75±1.16 cm, 23.79±1.22 cm, while those of the affected?side were 22.70 ± 0.98 cm, 22.41 ± 1.98 cm, 22.47 ± 1.12 cm and 21.92 ± 1.32 cm. The average D?values in each group were 0.19 ± 0.37 cm, 0.82±0.43 cm, 1.28±0.32 cm, 1.87±0.59 cm. The differences between the normal?side and the affected?side in each type were statistically significant. The average D?value increased significantly with Crowe type increased, and there was a positive correla?tion between the D?value of bilateral pelvic vertical height and the degree of hip dislocation. Conclusion The pelvic asymmetry does exist in adult patients with unilateral developmental dysplasia of the hip. Moreover, the asymmetry has positive correlation with the degree of hip dislocation.

Objective To explore the effects of comprehensive restraint reduction program on preventing un-planned extubation among ICU patients with tracheal intubation. Methods Totally 266 cases of ICU patients with tracheal intubation in our hospital were selected as the research objects using the convenient sampling method.They were divided into two groups by time: the experimental group of 130 cases implementing a comprehensive reduction constraint program and the control group of 136 cases using conventional physical restraint in nursing process.The constraint rate, constraint length, UEX incidence, skin and satisfaction of the two groups were compared. Results In the experimental group, the rate of physical restraint and UEX decreased, the average restraint length of each patient was shortened, skin integrity at the site of restraint improved, and the satisfaction of patients increased. Compared with the control group, the differences were statistically significant(P<0.01 or P<0.05). Conclusion The com-prehensive restraint reduction program can reduce the rate of physical restraint and the incidence of unplanned ex-tubation among ICU patients with tracheal intubation.