OBJECTIVETo evaluate the urodynamic characteristics of the chronic impairment of cauda equina caused by lumbar disk herniation.

METHODSClinical data and urodynamic parameters of 67 male patients with lumbar disk herniation were retrospectively analyzed. Lower urinary obstruction was excluded from the cohort using the Lin-PURR analysis. Patients were divided into group A (normal detrusor function), group B (detrusor underactivity) and group C (detrusor areflexia) according to the detrusor contraction function analyzed in Lin-PURR. Clinical data and urodynamic parameters were analyzed statistically between these groups.

RESULTSThe category of the detrusor contraction function had a significant effect on the urodynamic parameters. There were significant differences in the maximum flow rate (Q(max)), maximum pressure (P(max)), pressure at the maximum flow (P(det Qmax)) and post-voiding residual urine (PVR) among group A, B and C. There were significant differences in the first sensation volume of the bladder and the maximum cystometric capacity between group A and C, B and C, but no significance was found between group A and B. There was no significant difference in age, disease duration, and compliance of the bladder among 3 groups.

CONCLUSIONSUrodynamic study is important in exploring the severity of the chronic impairment of cauda equina caused by lumbar disk herniation. Detrusor areflexia and loss of bladder sensory indicate more severe degree of impairment of the cauda equine. Q(max) and PVR are helpful in early diagnosis of the chronic impairment of cauda equina.

Adult ; Aged ; Aged, 80 and over ; Cauda Equina ; Chronic Disease ; Humans ; Intervertebral Disc Displacement ; complications ; physiopathology ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; physiopathology ; Retrospective Studies ; Urodynamics

Objective To study the application effects of reflective practice in surgery clinic teaching.Methods 96 surgery exercitation nurses were randomly divided into two groups,study group ( n =48 ) and control group (n =48).The study group was taught with reflective practice,while the control group was given conventional teaching method. The teaching effects of both groups were evaluated comprehensively with a questionnaire and department rotation examination.Results Communication and expression ability,humanistic care towards operated patients,surgical cooperation ability,teamwork ability,and self-culture ability in the study group were significantly more excellent than those in the control group (x2 =15.10,17.14,8.49,19.10,6.98;P ＜0.01 ),the total score of the study group was (92.3 ±4.2),(79.5 ±3.8)for the control group,and there was significant difference between both groups ( t =15.65,P ＜ 0.05 ).Conclusions Reflective practice could promote the effects of surgery clinic teaching,develop and improve students' humanistic accomplishments and critical thinking ability.

Breast cancer is one of the leading causes of cancer death worldwide. This study aimed to analyze the expression of centromere protein H (CENP-H) in breast cancer and to correlate it with clinicopathologic data, including patient survival. Using reverse transcription-polymerase chain reaction and Western blotting to detect the expression of CENP-H in normal mammary epithelial cells, immortalized mammary epithelial cell lines, and breast cancer cell lines, we observed that the mRNA and protein levels of CENP-H were higher in breast cancer cell lines and in immortalized mammary epithelial cells than in normal mammary epithelial cells. We next examined CENP-H expression in 307 paraffin-embedded archived samples of clinicopathologically characterized breast cancer using immunohistochemistry, and detected high CENP-H expression in 134 (43.6%) samples. Statistical analysis showed that CENP-H expression was related with clinical stage (P = 0.001), T classification (P = 0.032), N classification (P = 0.018), and Ki-67 (P < 0.001). Patients with high CENP-H expression had short overall survival. Multivariate analysis showed that CENP-H expression was an independent prognostic indicator for patient survival. Our results suggest that CENP-H protein is a valuable marker of breast cancer progression and prognosis.
Adult ; Aged ; Aged, 80 and over ; Blotting, Western ; Breast ; cytology ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Cell Line ; Cell Line, Tumor ; Chromosomal Proteins, Non-Histone ; genetics ; metabolism ; Epithelial Cells ; cytology ; metabolism ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Rate ; Up-Regulation

Objective To evaluate the effect of process management of laparoscopic apparatus in sterilization and supply center with operating room.Methods The process management of laparoscopic apparatus in sterilization and supply center with operating room (OR) included the use and the process after using the laparoscopic apparatus in OR,as well as the receiving,cleaning,quality determination,packaging,sterilization and sending process in SSC.Effect before and after process management was compared.Results The qualified rates of sterilization and equipment packaging of laparoscopic apparatus and the nursing satisfaction were respectively (99.60 ± 0.38) ％,(98.40 ± 0.64) ％,(98.90 ± 2.84) ％ after process management,and (97.80 ±0.86) ％,(92.80 ± 1.32) ％,(86.14 ± 3.26) ％ before,and the differences were statistically significant (t =32.83,65.92,20.02,respectively;P ＜0.01).The cycle time and fault rate of laparoscopic apparatus were (2.12 ± 0.34) h and (0.24 ± 0.11) ％ after process management,and (2.68 ± 0.66) h and (0.56 ± 0.47) ％before,and the differences were statistically significant (t =2.60,11.48,respectively;P ＜ 0.01).Conclusions Process management of laparoscopic apparatus in sterilization and supply center with operating room can not only assure the cleaning and sterilization quality,but also improve the working efficiency,job satisfaction and nursing quality in OR as well.

OBJECTIVETo observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy (EHFT) combined with Chinese medicine (CM) in the treatment of patients with advanced nonsmall cell lung cancer.

METHODSThe study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM (the treatment group), the other only with CM (the control group). The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate (DCR) and time to progression (TTP). Secondary endpoints were overall survival time and 1-year survival rate.

RESULTSSixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease (28.8%), while the DCR of the control group was 63.3%, and 11 had progression of disease (36.7%); there was a significant statistical difference (P <0.05), suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time (MST) of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP (P <0.05), but no difference on MST or 1-year survival rate.

CONCLUSIONEHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; therapy ; Combined Modality Therapy ; Disease Progression ; Female ; Humans ; Hyperthermia, Induced ; Lung Neoplasms ; therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged

Objective Metformin (MET) can reduce blood glucose, act against inflammation, lessen oxidative stress and prevent fibrosis. This study was to investigate the protective effect of MET against acute lung injury (ALI) induced by paraquat poisoning (PQP) in rats. Methods Totally 78 healthy adult SPF male SD rats were randomly divided into five groups, normal control, PQP model control, and low-, medium- and high-dose MET. The PQP model was established in the latter four groups of rats by intraperitoneal injection of paraquat solution at 30 mg/kg and, at 2 hours after modeling, the rats in the three MET intervention groups were treated intragastrically with MET at 100, 400 and 800 mg/kg/d respectively, while those in the normal and PQP model control groups with the same amount of normal saline, all for 7 successive days. Six of the animals from each group were sacrificed at 1, 3 and 7 days and their lung tissues harvested for measurement of the wet/dry weight ratio of the pulmonary tissue and contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in the plasma, determination of the levels of serum interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) by ELISA, and observation of the pathological changes in the pulmonary tissue by HE staining. Results In the normal control, PQP model control and low-, medium- and high-dose MET groups, the contents of MDA were (2.53±0.36), (3.68±0.26), (3.57±0.52), (3.56±0.83) and (3.68±0.60) nmol/mL respectively on the 1st day of intervention and (2.53±0.36), (5.18±0.56), (5.09±0.88), (3.80±0.91) and (3.96±0.78) nmol/mL at 7 days; those of SOD were (256.18±18.18), (229.24±18.26), (224.65±19.27), (223.20±19.37) and (226.45±11.62) U/mL on the 1st day and (256.18±18.18), (152.06±17.03), (150.76±18.18), (205.95±13.16) and (208.37±12.23) U/mL at 7 days; those of IL-1β were (10.57±2.24), (21.97±5.03), (22.33±4.88), (21.78±5.21) and (22.11±4.19) pg/mL on the 1st day and (10.57±2.24), (91.86±8.40), (91.36±10.65), (63.52±7.06) and (60.35±6.70) pg/mL at 7 days; those of IL-6 were (21.35±2.62), (45.61±3.71), (44.83±5.97), (46.17±7.33) and (45.78±6.55) pg/mL on the 1st day and (21.35±2.62), (84.38±10.21), (85.88±6.70), (49.08±7.70) and (50.26±7.65) pg/mL at 7 days; and those of TNF-α were (32.37±3.74), (71.89±6.98), (72.52±8.23), (71.13±4.50) and (70.15±6.47) pg/mL on the 1st day and (32.37±3.74), (197.04±14.80), (201.59±13.61), (140.17±14.84) and (139.86±11.12) pg/mL at 7 days. Compared with the normal controls, the rats in the PQP model control and the MET intervention groups showed significant increases in the wet/dry weight ratio of the pulmonary tissue and contents of MDA, IL-1β, IL-6 and TNF-α (all P < 0.05), but a decrease in the SOD level in the plasma at 1, 3 and 7 days (P < 0.05). In comparison with the PQP model controls, the animals in the medium- and high-dose MET groups exhibited remarkable decreases in the wet/dry weight ratio of the lungs and contents of MDA, IL-1β, IL-6 and TNF-α (all P < 0.05), but an increase in the SOD level at 7 days (P < 0.05). Massive inflammatory cell infiltration, diffuse pulmonary hemorrhage, alveolar collapse and extensive alveolar septal thickening were observed in the PQP model control and low-dose MET groups but significantly alleviated in the medium- and high-dose MET groups at 7 days. Conclusion Metformin can protect paraquat-poisoned rats against acute lung injury by reducing pulmonary edema and the expressions of inflammation- and oxidation-related factors in the pulmonary tissue.

Objective To test the feasibility and accuracy of with sarcosaprophagous insects postmortem interval （PMI） estimation with sarcosaprophagous insects and provide references for estimation practice. Methods Eleven cases confirmed by the detection results, with complete entomological evidence were selected. The insect species, estimation results and true results involved in the cases were statistically analyzed and compared. Results Thirteen species of insects were found at the criminal scene, including Chrysomya megacephala （Fabricius）, Chrysomya rufifacies （Macquart）, Chrysomya nigripes （Aubertin）, Lucilia sericata （Meigen）, Hydrotaea spinigera Stein, Muscina stabulans （Fallén）, Sarcophagid （species were not identified）, Megaselia scalaris （Loew）, Hermetia illucens （Linnaeus）, Saprinus splendens （Paykull）, Creophilus maxillosus （Linnaeus）, Dermestes maculatus （De Geer） and Necrobia ruficollis （Fabricius）. The PMI of all eleven cases was within the range of estimated PMI. The estimated results of 72.73% cases were on the same day of the true results. Conclusion Sarcosaprophagous insects can estimate the PMI simply and conveniently. In cases where the PMI is within the time range of one generation of flies or beetles, the estimation results are relatively accurate. However, the estimation is less accurate when the PMI is beyond the time range.
Animals ; Autopsy ; Diptera ; Entomology ; Insecta ; Larva ; Postmortem Changes