Objective:To detect the pain status and the pain management of home-based advanced cancer patients, and to investigate the key factors impacting the satisfaction on pain management.Methods:Totally the data of 138 cases from the hospice department in the duration from Jan. 2019 to Jun. 2019 were collected and analyzed by χ2 test with SPSS 23.0. Results:109 cases in 138 cases received analgesics treatment before, 54.13% of these participants expressed satisfaction with the effect of their pain management, and 45.87% showed unsatisfied on their pain management. Cancer clinical stage and PMI (pain management index) were both detected to be the significant factors for satisfaction of pain management ( P<0.05, P=0.029; P<0.01, P=0.001) . Conclusions:Cancer clinical stage and PMI are found to be related to the satisfaction for pain management. The percentage of patients who use opioids increased. while there was still a part of patients suffering from inadequacy of pain management. The pain management for home-based advanced patients needs to be paid more attention by medical staff.

Posterior capsular opacification (PCO) is the most common complication that leads to loss of vision after cataract surgery.Neodymium doped:Yttrium-Aluminum-Garnet (Nd:Yag) laser capsulotomy is a common treatment for PCO, but still associated with several complications.In the past decades, the prevention and treatment of PCO have always been a hot spot of research in ophthalmology.This review will address the advances in the prevention and treatment of PCO in the aspects of surgical techniques and types of intraocular lens (IOL).

0. 05) , except that anemia and emaciation were more common in the elderly group than that in young group (P

Objective To reproduce a rabbit model of alginate immune pneumonia, and to study the pathogenic role of alginate on lung tissue. Methods Rabbits of group A, being challenged by saline, served as the control group. Rabbits of group B and C were immunized with seaweed alginate and bacterial alginate respectively. Body temperature,peripheral blood cells and the serum level of circulating immune complex (CIC) were measured after the challenge. Bronchoalveolar lavage fluid (BALF) specimens were incubated and bacterial colonies were counted. The cell number and differential count of BALF were made. The pathological changes of the lung tissue were observed under microscopy. Results In both seaweed alginate and bacterial alginate groups, the peripheral blood cell count and the number of bacterial colonies in BALF were similar to that of the saline group. However, the serum CIC levels and the cell count of BALF were increased significantly after the challenge. Under light microscopy, lymphocyte infiltration and lymphoid follicle formation around the bronchiolus were found in all alginate immunized groups, and there was also narrowing of bronchioli. Conclusion Both seaweed alginate and bacterial alginate could be used to establish the model of alginate immune pneumonia in rabbits. Alginate can cause inflammatory reaction and pathological changes in the rabbit lung, manifesting mainly peribronchilar lymphocytic infiltration and lymphoid follicle formation around the bronchioli.

Background Transforming growth factor-β1(TGF-β1) plays an important role in corneal woundhealing.The effects of TGF-β1 on the synthesis of extra cellular matrix (ECM) vary upon different concentrations.Previous studies focused on the effects of high concentration of TGF-β1 on keratocytes under the two-dimensional culture condition,and the effect of low concentration of TGF-β1 on the synthesis of ECM in keratocytes remains unclear.Objective This study was to investigate the growth of Pellet,a three-dimensional model of corneal stroma cells in vitro,and its ECM synthesis under a low concentration of TGF-β1.Methods Bovine corneal stromal cells were isolated from fresh bovine eyeballs by two-step digestion by collagenase and cultured using DMEM/F12 medium with 10％ fetal bovine serum (FBS).Pellets derived fresh bovine keratocytes with culture medium containing 0.25 ng/ml TGF-β1 +5％ FBS and 0.50 ng/ml TGF-β1 +5％ FBS were established,respectively.The morphology of Pellets was observed under the natural light at 48 hours,1 week,2 weeks and 3 weeks after culture.In 3 weeks after culture,the cell structures was observed by hematoxylin-eosin staining,and Calcein-AM/propidium (Calcein-AM/PI) staining was used to assay the cell viability.Real-time flurorescence quantitative PCR and immunofluorescence technology were applied to analyze the expressions of α-smooth muscle actin (α-SMA),fibronectin (FN),type Ⅰ collagen (Col Ⅰ) and type Ⅲ collagen (Col Ⅲ) mRNA and proteins.RT-PCR was employed to detect the expressions of lumican (LUM) mRNA and keratocan (KERA) mRNA in the cells.Results Cells in Pellet clustered throughout the culture duration.Hematoxylin-eosin staining showed the mass red-dyed collagen fibers in both 0.25 ng/ml TGF-β1 +5％ FBS group and 0.50 ng/ml TGF-β1 +5％ FBS group,and most cells possessed complete structures.The death rate of the cells was (33.60±1.65)％ in the 0.25 ng/ml TGF-β1 +5％ FBS group and (30.90±0.78) ％ in the 0.50 ng/ml TGF-β1 +5％ FBS group,showing an insignificant difference between them (t =0.144,P=0.887).The expressions of α-SMA,FN and Col Ⅲ proteins in 0.25 ng/ml TGF-β1 +5％ FBS group were lower than those in the 0.50 ng/ml TGF-β1 + 5 ％ FBS group (tα-SMA =4.622,P =0.010;tFN =2.973,P =0.040;tCol Ⅲ =7.845,P＜0.001),but the expression of Col Ⅰ in 0.25 ng/ml TGF-β1 +5％ FBS group was higher than that in 0.50 ng/ml TGF-β1+5％ FBS group (tColⅠ =4.022,P=0.016).The ratio of Col Ⅲ/Col Ⅰ in 0.25 ng/ml TGF-β1+5％ FBS group was lower than that in the 0.50 ng/ml TGF-β1 +5％ FBS group in both mRNA and protein level (tmRNA =-3.039,P =0.038;tprotein =3.215,P =0.032).The expression of LUM mRNA and KERA mRNA were detected in Pellet at different time points.The expression of LUM mRNA in 0.25 ng/ml TGF-β1 +5％ FBS group increased over time.While in 0.50 ng/ml TGF-β1 +5％ FBS group,the expression of LUM mRNA peaked at 1 week but declined at 2 weeks.The expression of KERA mRNA in two groups were all peaked at 1 week but declined at 2 weeks.Conclusions Low-dose TGF-β1 in Pellet can maintain the normal growth of keratocytes and synthesize ECM.The expression of ECM tends to the normal condition after reducing the concentration of TGF-β1,implying a scarless expression.

Objective To provide Meta-analysis evidence of laparoscopic partial nephrectomy (LPN) vs open partial nephrectomy (OPN) in assisting clinical decision making.Methods By searching CHKD,PUBMED,Wanfang and VIP database self-built library up to June 30,2012,both Chinese and English literatures of LPN and OPN efficacy in controlled study were included with strict exclusion criteria by two independent screenings of the literature.Data extraction and quality assessment were done by using the RevMan 5.1 META analysis software.Results A total of four English and six Chinese literature were included in this Meta-analysis.There were 1636 cases of partial nephrectomies.Of these patients,794 cases were treated with LPN,842 cases were treated with OPN.Meta analysis results showed that:in terms of operative time (SMD =0.10,95％ CI-O.40-0.59,P =0.70),surgical complication (OR =1.03,95％ CI0.73-1.44,P =0.88),positive surgical margin (OR =1.64,95 ％ CI0.83-3.23,P =0.16),warm ischemia time (SMD =1.07,95％ CI-0.02-2.16,P =0.05),postoperative tumor recurrence (OR =0.58,95％ CI 0.26-1.30,P =0.18),there was no significant difference.But in terms of intraoperative blood loss (SMD=-1.08,95％CI-1.57--0.59,P＜0.01),postoperative hospital stay (SMD=-0.81,95％CI-0.97--0.65,P ＜0.01),the differences were significant in favor of LPN.Conclusion Comparing with OPN,LPN has advantages in intraoperative blood loss and post-operative hospital stay,no obvious advantages in operative time,surgical complications,positive surgical margin,warm ischemia time and tumor recurrence.

Objective To prepare a new type of micropore porcine acellular dermis matrix with the aid of laser (LPADM),and to validate the healing effect of the LPADM through the phrase Ⅰ composite transplanting on the back of the full- thickness skin defects in SD rats.Methods In vitro,the allogeneic fibroblasts were separately cultured with the LPADM (LPADM group) or the non-pore PADM (non-pore LPADM group),while fibroblasts cultured by pure medium were used as control.After culture of 1 day,3 days and 5 days,the contents of IL-10,IL-6,TGF-β1,LN,VEGF expressed by fibroblasts were determined by double-antibody sandwich ELISA method.In vivo,the phrase Ⅰ transplantations of LPADM graft with split-thickness autologous skin were carried on the backs of the full-thickness cutaneous defects of SD rats.The healing condition was observed and analyzed by histological tests.Results The differences of the absorbance value between the LPADMgroup,PADM group and control group in each day were not statistically significant (F=0.050-1.763,P＞0.05).The transplantation of LPADM graft with split-thickness autologous skin graft resulted in high rate of surviving without signs of rejection 3 weeks later.After 1-month of transplantation,the regenerated skin was well enough to be lifted without any serious scars.Conclusions The phrase Ⅰ transplantation of LPADM graft with split-thickness autologous skin graft can accelerate the healing process of full-thickness skin wounds with high biological safety.

Objective To investigate the role of erythrocyte complement receptor type 1 (CR1) in the pathogenesis of chronic urticaria.Methods Venous blood samples were collected from 59 patients with chronic urticaria (including 14 cases of dermatographism and 45 chronic idiopathic urticaria) and 29 healthy human controls.Flow cytometry was carried out to quantify the expression level of CR1,and double-antibody sandwich enzyme-linked immunosorbent assay to determine the serum level of immunoglobulin E (IgE),complement C3,C4 and 50％ complement hemolytic activity (CH50).Differences in these parameters were analyzed by one-way ANOVA and independent samples t-test,and correlation between these paramenters by Pearson correlation analysis.Results The expression level (expressed as mean fluorescence intensity per 10 000 erythrocytes) of CR1 was significantly higher in patients with dermatographism and chronic idiopathic urticaria than in the healthy controls (35.06 ± 2.06 and 29.17 ± 1.53 vs.20.46 ± 2.57,t =4.20 and 3.33,both P ＜ 0.05),while no statistical difference was observed between the patients with dermatographism and chronic idiopathic urticaria (P ＞ 0.05).Increased total serum IgE levels were observed in patients with dermatographism and chronic idiopathic urticaria compared with the healthy controls ((769.89 ± 123.0) μg/L and (340.09 ± 29.74) μg/L vs.(107.63 ± 88.79) μg/L,t =5.58,5.85,both P ＜ 0.05),and in patients with dermatographism compared with those with chronic idiopathic urticaria (t =3.49,P ＜ 0.05).For patients with chronic urticaria,there was a statistical difference in the expression level of CR1 between individuals (n=22) with total serum IgE levels ranging from 0 to 240 μg/L and those (n =17) higher than 500 μg/L (24.45 ± 10.83 vs.33.09 ± 11.86,t =3.33,P＜ 0.05).The total serum IgE levels were positively correlated with the level of CR1 (r =0.27,P ＜ 0.05),but uncorrelated with that of complement C3 (r =0.16,P ＞ 0.05) or C4 (r =-0.08,P＞ 0.05).The level of complement C3 was positively correlated with that of C4 (r =0.54,P ＜ 0.01).One-way ANOVA revealed no significant difference in the serum levels of complement C3,C4,or CH50 between the patients with dermatographism,patients with chronic idiopathic urticaria and healthy controls (all P ＞ 0.05).Conclusion CR1 is abnormally expressed in patients with chronic urticaria.

Objective To explore the expression and significance of CD44 gastric cancer stem cell biomarker positive circulating tumor cells (CTC ) in peripheral blood of patients with gastric cancer . Methods From March 2010 to December 2012 ,45 patients with gastric cancer and 20 healthy individuals were enrolled .Peripheral blood samples of all the subjects were collected .The expression of CTC and CD44 postive CTC were detected by density gradient centrifugation method and double immunofluorescent staining .Chi‐square test and t‐test were performed for statistical analysis .Results CTC in peripheral blood of healthy controls were not detected .Among 45 patients with gastric cancer ,CTC were detected in 27 patients and 19 of them were CD44‐positive .The difference in positive rate of CTC expression was statistically significant between two groups (χ2 =10 .986 , P<0 .05) .Among 27 CTC‐positive patients , 19 were proximal gastric cancer and 16 of them were CD44‐positive;16 patients had lymph node metastasis and 14 of them were CD44‐positive;13 patients had distant metastasis and 12 of them were CD44‐positive;14 patients had recurrence and 13 of them were CD44‐positive .The CD44 positive CTC was correlated with tumor location ,lymph node metastasis ,distant metastasis and recurrence (χ2=5 .891 ,5 .527 ,5 .787 and 7 .052 ,respectively ,all P<0 .05) .Furthermore ,in 13 patients with recurrence and CD44 positive CTC ,the recurrence time was (10 .54 ± 5 .55) months which was shorter than that of one patients with CD44 negative CTC (19 months) ,and the difference was statistically significant (t= -3 .654 , P=0 .004) .Conclusions CTC which express cancer stem cell marker may be associated with recurrence and metastasis of gastric cancer .It has more important clinical significance to detect this subtype of CTC .

Objective To studythe efficacy of levosimendan in treating refractory heart failure complicating severe renal in sufficiency.Methods Sixty-seven cases of refractory heart failure complicating severe renal insufficiency in the internal medicine department of our hospital were randomly divided into the levosimendan treatment group(L group,n=33)and dopamine treatment group(D group,n=34).The changes of N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction (LVEF)and glomerular filtration rate(GFR)before treatment and on 1,3,7,30 d after treatment were compared between the two groups and analyzed.Results Before the treatment,there were no statistically significant differences in the baseline indicators between the two groups(P＞0.05).The group L:the NT-pro-BNP level on 1,3,7 d after treatment was decreased significantly(P＜ 0.05),LVEF on 3,7 d was significantly increased compared with th baseline(P＜0.05)and GFR on 1,3,7,30 d was significantly increased compared with the baseline(P＜0.05).The group D:the NT-pro-BNP level on 7 d of treatment was significantly decreased(P＜0.05),LVEF on 7 d of treatment was significantly increased compared with the baseline(P＜0.05),and no statistically significant changes were observed in GFR on 1,3,7,30 d(P＞0.05).After treatment,NT-pro-BNP,LVEF and GFR significant level values in the group L were better than those in the group D.Conclusion Levosimendan is superior to dopamine in improving heart and renal function for the patients with refractory heart failure complicating severe renal insufficiency.