Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

Anion Exchange Protein 1, Erythrocyte ; metabolism ; Biomarkers ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Medullary ; metabolism ; pathology ; surgery ; Carcinoma, Transitional Cell ; metabolism ; pathology ; Child ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Kidney Tubules, Collecting ; pathology ; Mucin-1 ; metabolism ; Nephrectomy ; Rhabdoid Tumor ; metabolism ; pathology ; Vimentin ; metabolism

ObjectiveTo investigate the sleep status and effect of night shift work on sleep in nurses.MethodsSleep characteristics and qualities of 348 nurses, 50 communication persons and 100 night-guards were analyzed with Pittsburgh Sleep Quality Index (PSQI), and insomnia was diagnosed based on DSM-IV criteria.Results71.86% of nurses had bad sleep quality (PSQI>7); the rate of insomnia was 38.22%. The same data were 74% and 48% respectively in communication persons, and 26.76% and 7% in night-guards. The sleep quality of nurses was related to age and years of night shift work. The sleep quality of nurses was similar to communication persons (P>0.05), but significantly different from that of night-guards (P<0.01).ConclusionShift work manner influences sleep status of nurses and makes them having disturbances on falling sleep time, the time of sleeping, sleep efficiency and daytime function. But it doesn't need medication.

Objective To explore a desirable therapeutic regimen,which is effective,reasonable and practicable for locally advanced nasopharyngeal cancer (LA-NPC) patients in the era of IMRT,with a potential of translating into survival improvement of these patients.Methods Patients presented with stage Ⅲ-Ⅳ B,WHO type Ⅱ or Ⅲ NPC were randomly assigned to receive concurrent chemoradiotherapy (CCRT group) (45 cases) or induction chemotherapy plus radiotherapy alone (IC + RT group) (43 cases),with random number table.IMRT and rapid arc planning were generated in the same treatment planning system for all patients.These two arms received docetaxel plus cisplatin for first cycle of chemotherapy,and cisplatin only for the second cycle.Results Forty-five patients received CCRT and 43 received IC + RT.All the patients completed two cycles chemotherapy.Compared to the CCRT group,the incidence rate of grade 2-4 leukopenia was lower in IC + RT group[67.4 ％ (29/43) vs.86.7 ％ (39/45),x2 =4.628,P =0.031],while the incidence rate of dermatitis,mucositis,neutropenia and fungal infection of oral cavity had no significant differences (all P ＞ 0.05).The tumor response rate (95.3 ％ vs.100.0 ％,P =0.236),2-year overall survival rate (95.5 ％ vs.94.2 ％,P =0.627),2-year progression free survival rate (94.6 ％ vs.88.6 ％,P =0.303),2-year local recurrent free survival rate (97.3 ％ vs.95.5 ％,P =0.951),2-year regional recurrent free survival rate (94.7 ％ vs.96.2 ％,P =0.949),and 2-years distant metastasis free survival rate (93.7 ％ vs.91.5 ％,P =0.454) of the two groups were similar while comparing CCRT to IC + RT group.Conclusion Combined IMRT with TP/DDP regimen,the efficacy of IC + RT is similar to CCRT for LA-NPC.The IC + RT group has less severe leukopenia than CCRT group,which is worth further study.

Objective:To summarize the clinical features, genetic testing and treatment efficacy of 6 children with Dent disease.Methods:Six children diagnosed with Dent disease in Guangzhou Women and Children′s Medical Center from January 2014 to March 2019 were enrolled.Their medical history, clinical manifestations, laboratory results, genetic test results, and proteinuria level, calciuria level and renal function after medication were measured.Results:All patients were male, with the onset age ranged from 1 to 9 years old.They were followed up for 6 months to 4 years.All the children had low molecular weight proteinuria.Urine protein electrophoresis showed that the ratio of low molecular weight proteinuria in only 2 cases was more than 50%.Renal biopsy suggested that all cases were combined with glomerular lesions.Five cases had hypercalciuria.Under the microscope, there were 5 cases of hematuria.Two case had rickets, and there was no renal calcium deposition and hypophosphatemia.Five cases were detected with CLCN5 mutations, of which p. C160Yfs*49 and p. G523D were first reported.One case had an OCRL1 mutation.Patients were treated with Hydrochlorothiazide and angiotensin converting enzyme inhibitor (ACEI). The 24 h urinary calcium level after treatment was lower than that before treatment [0.40 (0.24, 0.43) mmol/kg vs.0.12 (0.11, 0.14) mmol/kg, U=2.00, P<0.01]. However, there was no significant decrease in the 24 h-urinary protein level before and after treatment [77.09 (62.41, 88.01) mg/kg vs.80.33 (66.03, 92.52) mg/kg, U=12.00, P>0.05]. Conclusions:Dent disease is mainly characterized by low molecular weight proteinuria, and some patients may not be associated with hypercalciuria.Gene tests help to identify the disease type.ACEI and Hydrochlorothiazide can reduce the urinary calcium level, but cannot improve the level of urinary protein.

The authors adopted acupuncture plus auricular electro-acupuncture to treat 38 cases of dysmenorrhea belonging to qi stagnation and blood stasis pattern, the better therapeutic effect was achieved, with the effective rate of 97.4%.

OBJECTIVETo study the effect of Ti-TiO2 nanotubes with different diameters on the adhesion of fibroblast and osteoblast, and to find which diameter was more favorable for cells' respective adhesion.

METHODSPure titanium sheets were polished and then anodized at different potentials for 1 h with Ti as anode and Pt as cathode. TiO2 nanotubes formed at 1, 5, 10 and 20 V potentials served as experimental groups and polished pure titanium served as control group. Field emission scanning electron microscopy (Fe-SEM) was used to analyze the surface topography. Stained nucleus with Hoechst33342 were used to measure the cell adhesion. The cell shape on the sample surface were analyzed with Fe-SEM.

RESULTSTiO2 nanotube array of different inner diameters from 15 nm to 100 nm were grown on titanium sheets by anodization at potentials from 1 to 20 V. At 30, 60 and 120 min, fibroblast adhesion at nanotubes anodized at 5 V was (141 ± 9), (388 ± 14) and (489 ± 15) respectively, significantly less than any other nanotube surface at the same time (P < 0.01). Nanotubes anodized at 20 V had the least inhibitory effect for fibroblast adhesion with a number of (579 ± 14) at 120 min, and the cell shape was also inhibited. At 30, 60 and 120 min, osteoblast had a significant better adhesion on nanotubes formed at 5 V than it did on any other surface at the same time (P < 0.01), except the control group at 30 min, with the adhesion number of (198 ± 10), (431 ± 10) and (501 ± 10) respectively, and osteoblast had a abundant spread on nanotubes formed at 5 V; while osteoblast adhesion on nanotubes anodized at 20 V was (152 ± 11), (403 ± 9) and (465 ± 12) respectively, less than on any other nanotube surface within the same time (P < 0.05), and the cell shape on the surface changed to be more elongate.

CONCLUSIONSFibroblast adhesion is inhabited more or less on Ti-TiO2 nanotubes of different diameters. Nanotubes formed at 5 V have the most osteoblast adhesion, and inhibit fibroblast adhesion.

Animals ; Cell Adhesion ; Fibroblasts ; cytology ; ultrastructure ; Mice ; Microscopy, Electron, Scanning ; Nanotubes ; chemistry ; Osteoblasts ; cytology ; ultrastructure ; Surface Properties ; Titanium ; chemistry

Objective: To improve the understanding of the clinical feature and early diagnosis of relapsing polychondritis(RP). Method: Eleven patients with RP were analyzed retrospectively and the reported literatures were reviewed. Result: Nine cases had initial involvement of auricular cartilage while two polyarthritis. The treatment of 2RP patients with respiralory tract involvement was invalid and 1 patient died. Nine cases were initially misdiagnosed, with a misdiagnosis rate of 81.82%. Conclusion: RP involves cartilage and connective tissue. The prognosis with respiralory tract involvement is poor. RP is a sort of paroxysmal and progressive inflammation involving cartilages all over the body with a variety of clinical manifestations. Early diagnosis of RP is based on full understanding of its clinical features.

Transforming growth factor-?1 (TGF-?1) was reported to play an important role in the pathogenesis of asthma in many stu-dies.It can stimulate the growth of fibroblast and give rise to fibrosis of lung tissues.Many scholars think that TGF-?1 is closely related to airway remodeling.It is a breakthrough to aim at TGF-?1 to find a way to intervene remodeling in asthma.Glucocorticoid (Dexamethasone and Budesonide) can have an impact in some extent to airway remodeling.In addition,interferon-? and some traditional chinese medicine such as ligustrazine,tripterygium wilfordii and ginkgo maybe effective,they all may ameliorate the progression of airway remodeling following redu-cing partial airway TGF-?1 expression.

AIM:To compare the clinical effects of 25G+ and 27G+ transconjunctival sutureless vitrectomy in treating idiopathic macular hole.METHODS: We retrospectively reviewed the clinical outcomes of 56 eyes (56 patients) with idiopathic macular hole which were treated with micro-incision vitrectomy from June 2015 to September 2016.Patients were divided into two groups, 28 patients (28 eyes) were treated with 25G+ vitrectomy and the rest (28 eyes) were treated with 27G+ vitrectomy.The operative time and intraoperative complications were recorded and patients were followed up for 3-6mo.During the follow up period, best correct vision acuity (BCVA), intraocular pressure, macular hole healing and postoperative complications were documented and statistically analyzed.RESULTS: BCVA in two groups were significantly improved after surgery(P<0.001) and there was no significant difference between the two groups(P=0.84).No serious complications occurred.No statistically significant difference was found between the two groups in surgical time and healing rate of macular hole (P=0.57, 0.64).The incidence of low intraocular pressure (IOP<10mmHg) in 27G+ group was lower than that in 25G+ group on the first day after surgery(P=0.31).There was no significant difference between preoperative and postoperative intraocular pressure at 1wk after operation in both groups (P=0.72, 0.92).CONCLUSION: Both 25G+ and 27G+ vitrectomy are safe and effective technique in treating idiopathic macular hole.Besides, 27G+ showed better superiority on the maintenance of intraocular pressure and reduce the trauma.