Objective To investigate the changes and significance of concentration of soluble intercellular adhesion molecule-1(sICAM-1) in cerebrospinal fluid (CSF) of bacterial meningitis(BM) in rabbits. Methods A total of 36 rabbits were randomly divided into m eningitis group, meningitis cefotaxime-treated group and control group. BM indu ced by escherichia coli(Ec) via cerebellomedullary cistern inoculated. Normal sa line was injected in control group. CSF was sampled in different time. The conce ntration of CSF sICAM-1 was detected by ELISA.Results 1.There was a low concentration of sICAM-1 in CSF in 85 percent of normal rabbi ts.2.In meningitis group, there was a sharp rise in the concentration of CSF sIC AM-1 at 6 hours after Ec was inoculated, reached a peak level at 12 hours, and t here was higher concentration of CSF sICAM-1 between 6 and 24 hour than that at 0 hour.3.In meningitis cefotaxime-treated group, the concentration of CSF sICAM -1 at 6 hour and 12 hours was similar to meningitis group, the time that get pe ak level was at 24 hours that at 12 hours after making use of antimicrobial agen t.The peak level was higher than meningitis group. The concentration of CSF sICA M-1 decreased markedly at 48 hours that made use of antimicrobial agent 36 hour s later,but the concentration was still higher than the peak level of meningitis group.Afterwards, with the time of making use of antimicrobial agent lengthened ,the concentration of CSF sICAM-1 decreased gradually.4.Experimental results in dicated by correlating analysis to these data that there was positive correlatio n in the concentration of CSF sICAM-1 with the brain water content.Conclusions sICAM-1 participates in the pathological process of BM, and contributes to the damage of blood brain barrier and the formation of brain edema.There is importan t significance that drugs which can resist the discharge of sICAM-1 will be impl ied. J Appl Clin Pediatr,2005,20(2):163-165

Objective To provide the evidence for clinical psycho-nursing through surveying the Medical Coping Questionnaire (MCMQ) of different-scoliosis patients.Methods 124 scoliosis patients were investigated with MCMQ charts,with 59 cases of idiopathic-scoliosis(group A)and 65 cases of congenital-scoliosis (group B).Results MCMQ composed of confrontment,avoidance and resignation.The scores of confrontmcnt,avoidance and resignation were (18.66±3.13),(16.46±2.89) and (10.63±2.78)in group A,and(18.97±3.97),(16.57±2.84) and (10.75±2.54) in group B.The average score of the three subjects in group A was less than that in group B,and there was a significant difference in confrontment(P<0.01),but no significant difference in avoidance and resignation(P>0.05).Further investigating the three subjects in group A,the difference was significant in resignation(P<0.05),but not significant in confrontment and avoidance (P>0.05) when compared to group B.Conclusions The results of MCMQ in difierent scoliosis are different.The clinical nurses must evaluale the medical coping level.and specially be careful for the complexity of psychological reaction in idiopathic-scoliosis patients.It is to reduce or eliminate the inactivecoping through effective method of psychological therapy,thereby making the patients receive the operation therapy in the healthy state of psychology.

BACKGROUNDPain is a common burden of disease globally; yet, it is not systematically investigated in China, especially in hospitalized patients. This study was aimed at clarifying the epidemiological characteristics of pain and related factors in hospitalized patients in Southwest China.

METHODSA cross-sectional study was conducted to investigate the prevalence, severity, and influencing factors of pain and modes of postoperative analgesia in hospitalized patients from 17 hospitals in Southwest China. A prevalidated questionnaire was employed to calibrate all of these items within 3 days from March 18, 2015 to March 20, 2015.

RESULTSA total of 2293 patients were surveyed, the incidence of pain was 57.4% in all hospitalized patients at rest, of which 62.1% were with acute pain and 37.9% had persistent to chronic pain. Among surgical patients, 90.8% of them complained of acute postoperative pain at rest and 97.1% in motion. The incidence of acute postoperative moderate-to-severe pain was 28.8% at rest and 45.1% in motion. Surgical patients reported higher incidences of pain, especially acute and persistent pain compared with nonsurgical patients (P < 0.05). Postoperative pain occurred predominately at surgical sites (95.2%) as compared with nonsurgical sites (4.8%). Agedness, lower education level, surgery, and history of smoking were factors associated with increased duration and severity of postoperative pain and nonsurgical pain (P < 0.05).

CONCLUSIONSPain is a common burden of disease in China, of which surgical pain constituted an important component. Surgical patients complained more severe pain than those who did not undergo surgery. Postoperative analgesia still needs to be improved to control pain after surgery. Patients' perception might influence the efficacy of pain management, which should be implemented with a multidisciplinary approach.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Pain ; epidemiology ; etiology ; Pain Management ; Pain Perception ; Pain, Postoperative ; epidemiology

OBJECTIVETo analyze the clinical features and diagnostic points of occupational acute dimethylformamide (DMF) poisoning and to explore the mechanism of occupational acute DMF poisoning.

METHODSA comprehensive analysis was performed on the clinical data of 16 cases of occupational acute DMF poisoning, including symptoms, signs, and laboratory testing results.

RESULTSThe main clinical features of occupational acute DMF poisoning were digestive system impairments, especially abdominalgia. Hemorrhagic gastroenteritis was not found by gastroscopy. There was no significant correlation between the degree of abdominalgia and alanine aminotransferase level (r(s) = 0.109, P>0.05).

CONCLUSIONAbdominalgia is recommended to be one of the reference indices for the diagnosis and degrading of occupational acute DMF poisoning, The mechanism of DMF poisoning remains unclear but it is considered to be related to methyl isocyanate, the intermediate product of DMF metabolism.

Abdominal Pain ; chemically induced ; Alanine Transaminase ; metabolism ; Dimethylformamide ; poisoning ; Humans ; Occupational Exposure ; Solvents ; poisoning

OBJECTIVETo evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy.

METHODSA total of 105 patients received the operation with age ranging from 51 to 73 years from January 2008 to June 2010. Mean level of serum prostate specific antigen was 13.6 µg/L and mean prostatic volume was 45 ml. Pathological studies of biopsy confirmed the prostate carcinoma with Gleason score 6-8. Radionuclide bone scan revealed no metastasis. Based on previously retroperitoneal radical prostatectomy, modified technique was applied involving surgical approach, bladder neck dissection and vesicourethral anastomosis.

RESULTSMean operative time was 93 min (65 - 150 min). Intraoperative blood loss was 115 ml (50 - 400 ml). No complication of bowl injury occurred. Positive surgical margin was present in 24 patients. Normal continence were seen in 64 patients after catheter removed. Recovery of incontinence within 3 months was seen in 33 patients and 3 to 12 months in 5 patients respectively. Three patients with incontinence were still in the follow-up.

CONCLUSIONSTransperitoneal laparoscopic radical prostatectomy provides large working space and clear anatomic exposure. Higher efficiency and lower complication rate are obtained through modified laparoscopic technique involving seminal vesicle isolation, bladder neck dissection and vesicourethral anastomosis.

Abdominal Cavity ; surgery ; Aged ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Retrospective Studies

The purpose of this study was to compare monotonic biomechanical properties of gourd-shaped LCP fixation with LCP fixation of human tibial shaft in gap fracture mode. Twenty paired fresh cadaveric human tibias were randomly divided into 4 groups (5 pairs each): (1) axial loading single cycle to failure testing, (2) torsion single cycle to failure testing, (3) 4-point bending single cycle to failure testing, and (4) dynamic 4-point bending testing. A 7-hole 4.5 mm gourd-shaped LCP was secured on the anteromedial surface of 1 randomly selected bone from each pair, respectively, using 6 locking screws in the 1st, 2nd, 3rd, 5th, 6th and 7th hole with the middle hole unfilled and just located at the mid-diaphysis of the tibia. A 7-hole 4.5 mm LCP was secured on the other bone with the same method. Standard AO/ASIF techniques were used. After fixation finished, a 10 mm gap in the mid-diaphysis of tibia was created, centrally located at the unfilled hole. The axial, torsional, and bending stiffness and failure strengths were calculated from the collected data in static testings and statistically compared using paired Student's t-test. The 4-point bending fatigue lives of the two constructs were calculated from the dynamic testing data and also statistically compared using paired Student's t-test. Failure modes were recorded and visually analyzed. P<0.05 was considered significant. Results showed that the axial, torsional and bending stiffness of gourd-shaped LCP construct was greater (4%, 19%, 12%, respectively, P<0.05) than that of the LCP construct, and the axial, torsional and bending failure strengths of gourd-shaped LCP construct were stronger (10%, 46%, 29%, respectively, P<0.05) than those of the LCP construct. Both constructs failed as a result of plate plastic torsional deformation. After axial loading and 4-point bending testings, LCP failed in term of an obvious deformation of bent apex just at the unfilled plate hole, while the gourd-shaped LCP failed in term of a deformation of bent arc between the 3rd and 5th holes, which indicated a more consistent stress distribution on gourd-shaped LCP. Fatigue life of gourd-shaped LCP construct was significantly greater than LCP construct (153 836±2 228 vs. 132 471±6 460 cycles, P<0.01). All constructs failed as a result of fracture of the plate through the compression hole of the unfilled combination screw hole. The biomechanical testing showed that gourd-shaped LCP can provide greater stiffness and strength, and longer fatigue life than LCP. The gourd-shaped LCP may be more advantageous mechanically and may reduce the plate breakage rate clinically.
Bone Plates ; Compressive Strength ; Elastic Modulus ; Equipment Failure Analysis ; Fracture Fixation, Internal ; instrumentation ; Humans ; In Vitro Techniques ; Prosthesis Design ; Stress, Mechanical ; Tensile Strength ; Tibial Fractures ; physiopathology ; surgery

The pathological changes of the heart after myocardial infarction （MI） are complex， involving multiple molecular mechanisms and various cells， such as myocardial cells， endothelial cells， fibroblasts， and macrophages. With multiple targets， Chinese medicine demonstrates ideal cardioprotective effect. However， the complex mechanism of multi-component Chinese medicine formulas has not been elucidated， thus limiting the further application. The high-throughput single-cell RNA sequencing （scRNA-seq） technology offers single-cell transcriptome analysis of hundreds of drugs under different processing conditions in a single experiment and identifies the differences in the response of different cells and cell subtypes to drug treatment. scRNA-seq technology helps us to understand the exact cellular and molecular mechanisms of cardiac remodeling from acute ischemic events to chronic cardiac scarring. The application of scRNA-seq to studying the cardioprotective mechanism of Chinese medicine after MI can boost the development of Chinese medicine， help obtain richer， more accurate and comprehensive information. It can give us a clear insight into the mechanism of Chinese medicine based on complex network. In this study， we summarized the research on cardioprotective mechanism of Chinese medicine and introduced the development of scRNA-seq technology and the application to MI research. Finally， we explored the possible application prospects of scRNA-seq in the research on cardioprotective mechanism of Chinese medicine after MI， hoping to provide ideas for the modernization of Chinese medicine.

BACKGROUND: Patients' recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients' recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored. METHODS: A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed. RESULTS: A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P < 0.050). The subscores of life ability and physical well-being at post-operative 72 h were significantly improved in the group PR-ERAS using quality of recovery score (QOR-40) questionnaire (P < 0.050). The strength of hand grip post-operatively was also improved in the group PR-ERAS (P < 0.050). The incidence of bowel-related and other adverse events was similar in both groups till 30 days post-operatively (P > 0.050). CONCLUSIONS: Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR-ONRC-14005096.
Colorectal Neoplasms ; Hand Strength ; Humans ; Length of Stay ; Postoperative Complications ; Preoperative Exercise ; Quality of Life ; Randomized Controlled Trials as Topic ; Recovery of Function

Objective To improve indexes of pre-operative pulmonary function and operative tolerance,as well as to avoid accidental risks during operation by using gradual training methods of breathing function for patients with scoliosis.Methods Totals of 70 patients with scoliosis from July 2011 to July 2012 were chosen and trained with gradual methods of breathing function for 7 to 10 days.One nurse was in charge of guidance,evaluation and recording.Indexes of pulmonary function,including breathing capacity,maximal ventilatory capacity and percentages among predicted value,were compared before and after training.Results Average maximal ventilatory capacity and training frequency were respectively (1 877.22 ± 672.21)ml and (320.60 ±123.40) times/d after training,both higher than (1 466.12 ± 720.10) ml and (102.40 ± 48.20) times/d before training,and the differences were statistically significant (t =4.02,6.88,respectively; P ＜ 0.01).There was no statistically significant difference of pulses and degree of blood oxygen saturation before and after training.Breathing capacity and its percentage among predicted value,maximal ventilatory capacity and its percentage among predicted value were respectively (2.48 ± 0.70) L,(70.40 ± 12.34) ％,(58.21 ± 10.01) L and (90.44 ± 15.40) ％ after training,all of which were higher than (1.80 ± 0.65) L,(62.34 ± 10.17) ％,(47.02 ± 11.32)L and (83.80 ± 13.20)％ before training,and the differences were statistically significant (t =3.51,2.88,4.15,3.33,respectively; P ＜ 0.01).Conclusions Gradual training methods of breathing function on patients with scoliosis can improve their pre-operative pulmonary function,which provides technical support for patients' adoption to operations,reduction of risks and further training of breathing function,thus worthy of promotion.

Objective:To observe the G protein-coupled receptor 48 (GPCR48) expression in hepatocellular carcinoma (HCC) cell lines with different metastatic potential and its characteristics effect on the invasion and metastasis of Huh7 hepatoma cells via epithelial-mesenchymal transition (EMT).Methods:Western blot was used to detect the protein expression level of GPCR48 in HCC cells with different metastatic potential. The lentivirus vector expressing GPCR48 gene was constructed. GPCR48 was overexpressed in Huh7 hepatoma cells. The GPCR48 overexpression level was detected by real-time PCR and Western blot. Transwell invasion and migration assay was used to detect the Huh7 hepatoma cells invasion and migration ability in the Control, Mock and GPCR48 overexpression group. Real-time PCR and Western blot were used to detect Huh7 hepatoma cells mRNA and protein expression levels of the EMT related markers (E-cadherin, N-cadherin, vimentin, and γ catenin) in the Control, Mock and GPCR48 overexpression groups, respectively. Analysis of variance was used to compare the differences between data sets.Results:GPCR48 protein expression level in metastatic HCC cell lines was significantly higher than non-metastatic HCC cell lines ( P < 0.05). The lentivirus vector expressing the GPCR48 gene had effectively transfected the Huh7 hepatoma cells and stably expressed the GPCR48mRNA and protein. Compared with the Mock and the Control group, Huh7 hepatoma cells invasion and migration ability in the GPCR48 overexpression group was significantly enhanced ( F≥5.54, P < 0.05), and the mRNA and protein expression levels of epithelial phenotypic markers E-cadherin and γ-catenin were decreased ( P < 0.05). The mRNA and protein expression levels of the mesenchymal phenotypic markers N-cadherin and Vimentin were increased ( P < 0.05), indicating that EMT changes occurred in Huh7 hepatoma cells had overexpressed GPCR48. Conclusion:GPCR48 expression level is positively correlated with the metastatic potential of HCC cells. GPCR48 overexpression can down-regulate the expression of epithelial phenotypic markers and up-regulate the expression of mesenchymal phenotypic markers, and induce EMT changes in HCC cells, thus promoting HCC cells invasion and migration.