Objective:To explore the clinical effect of positive reinforcement theory nursing intervention in the rehabilitation treatment of patients with cervical spondylosis and its influence on cervical function and quality of life.Methods:From March 2017 to May 2020, 94 patients who received rehabilitation after anterior cervical decompression surgery were selected as the research samples. They were divided into the control group and the study group by random digits table method with 47 cases in each group. The control group was given routine nursing care, and the study group received positive reinforcement theoretical nursing intervention on the basis of the control group.The nursing effect,cervical vertebra function and quality of life before and after nursing were evaluated by Visual Analogue Scale(VAS), Japanese Orthopaedic Association assesses treatment(JOA) score, SF-36. The nursing satisfaction rate was evaluated by questionnaire.Results:The JOA score, quality of life score and VAS score of the study group before nursing were (7.57 ± 1.35), (56.78 ± 5.62), (6.53 ± 0.34) respectively, while those of the control group were (7.32 ± 1.27), (56.32 ± 5.31), (6.32 ± 0.31) respectively, and there was no significant difference between the two groups ( P > 0.05). The JOA score and quality of life score of the study group after nursing were (15.73 ± 0.33) and (91.67 ± 2.34) respectively, which were higher than those of the control group (12.18 ± 0.46) and (83.43 ± 3.33) respectively. The VAS score of the study group after nursing was (2.33 ± 0.11) and lower than that of the control group (4.53 ± 0.25). The differences were statistically significant ( t values were 3.47, 5.43, 4.67, P< 0.05). Compared with the control group, the nursing satisfaction rate of the study group was higher than that of the control group (85.11%, 40/47 vs. 97.87%,46/47, χ2 value was 4.92, P < 0.05). Conclusions:Positive reinforcement theory nursing intervention can effectively relieve the pain symptoms of patients, improve the cervical function, and effectively improve the quality of life.

Objective:To study the effect of comprehensive nursing combined with cervical spine health care on postoperative psychological status and the prevention of various complications of patients with cervical spine surgery.Methods:A total of 102 patients who underwent cervical spine surgery in Dalian Third People′s Hospital from June 2018 to February 2020 were selected as the research objects. The patients were randomly divided into a control group and an experimental group. The control group was given routine care, and the experimental group was given comprehensive care combined with cervical spine for health care intervention, the main observation indicators included the mental state of the two groups of patients, the incidence of postoperative complications, and the patients' satisfaction with nursing work.Results:After comprehensive nursing combined with cervical health care intervention, the SAS score of the control group was 50.14±3.51 and the SAS score of the experimental group was 30.27±1.12. The SAS score of the control group was significantly higher than that of the experimentalgroup ( t value was 24.134, P< 0.05); the SDS score of the control group was 50.45±1.11, the SDS score of the experimental group was 39.45±2.21, the SDS score of the control group was significantly higher than that of the experimental group ( t value was 20.293, P<0.05), the difference was statistical significance: Compared with the control group (27.45%,14/51), the incidence of postoperative complications (9.80%,5/51) in the experimental group was significantly reduced ( χ2 value was 10.409, P<0.05); the nursing attitude of the patients to nursing staff (91.11± 5.32), nursing quality (90.41±2.30), nursing responsibility (92.82±4.69) in the experimental group were all significantly higher than those of the control group (80.67±3.51, 80.21±4.43, 80.78±4.82), the difference was statistically significant ( t value was 9.151, 14.671, 16.124, P<0.05). Conclusion:Rehabilitation nursing intervention of comprehensive nursing combined with cervical spine health care can improve mental state, reduce incidence of complication and increase satisfaction degree for patients undergoing cervical spondylopathy surgery, which is worthy of further clinical application and promotion.

Objective To observe the operation of Nav1.6 voltage-gated sodium channels in rats with acute cerebral injury after electroacupuncture therapy and investigate the mechanism.Methods Male Sprague-Dawley rats were randomly divided into an ischemia control group (IC,n =48),an electroacupuncture group (ET,n =48),a nimodipine therapy group (NT,n =48) and a sham operation group (SO,n =24),and were treated accordingly.A model of acute cerebral ischemia was induced by occlusion of the right middle cerebral artery using the suture method.The expression of Nav1.6,the concentration of Ca2+ and infarct volume were observed at 6 h,1 d,2 d and 3 d after ischemia with the real-time quantitative fluorescence PCR,immunofluorescence and 2,3,5-triphenyl tetrazolium chloride methods,respectively.Results The Joshua score for neural function was zero in the sham operation group,and increased gradually in the three other groups 6 h and1 and 2 d after ischemia.The average Joshua score 3 d after ischemia was significantly lower than 1 d earlier in each group.In the ET group the expression of Nav1.6 was significantly upregulated at first,followed by a significant decrease.The concentration of Ca2+ behaved similarly.However,no significant changes were observed in the infarction volume percentage.At 3 d after ischemia the expression of Nav 1.6,the Joshua grades,the Ca2+ concentrations and the infarction volume percentage were all significantly lower in the ET group compared with the IC,NT and SO groups.Conclusion Electroacupuncture therapy after acute cerebral ischemia can inhibit the expression of Navl.6,reduced Na + inflow and calcium overload,and mitigate acute cerebral ischemic injury,at least in rats.The protective effect may be attributed to inhibiting the expression of Nav 1.6.

Objective More early esophageal cancers are treated by endoscopy.However,whether submucosal patients are suitahle for endoscopic treatment is still controversial,and few domestic researches were conducted in this area.The present study investigated the impact of submucosal invasion depth on lymph node metastasis.Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied.Submucosal invasion was equally categorized into inner one-third(sml),middle one-third(sm2),and deep one-third(sm3) invasion by pathologists.Demographics of patients,tumor characteristics,and surgical information were retrospectively collected through medical records.They were compared according to different submucosal invasions.Cancer characteristics and its association with LNM were analyzed by univariate and multivariate analysis.Results The study included 75 sml (29.1％),73 sm2(28.3％),and 110 sm3(42.6％) patients,and the rates of LNM were 12.0％ (9/75),11.0％ (8/73),20.9％ (23/110),respectively.sm3 might be associated with regional LN M (univariate analysis,P =0.041).Tumor volume ＞ 1.856 cm3 (P =0.022) and lymphovascular invasion (P =0.004) predicted LNM using multivariate analysis.Conclusion Submucosal ESCC showed a substantial rate of LNM and it seems that they are not suitable for endoscopic treatment.Depth of invasion was not an independent risk factor for LNM.

Objective To detect the expression of translationally controlled tumor protein (TCTP) in squamous cell carcinoma (SCC) tissue and cell lines A431 and SCL-1,and to evaluate the effect of TCTP on apoptosis in and proliferation of SCC cells.Methods An immunohistochemical method was used to measure the expression of TCTP in tissue specimens from 65 patients with SCC.Western blot was performed to detect the expression of TCTP in A431 and SCL-1 cells.Three small interference RNAs (siRNAs) targeting the TPT1 gene were designed,synthesized,and transfected into A431 cells.Then,reverse transcription (RT)-PCR and Western blot were conducted to measure the expression of TPT1 mRNA and TCTP,respectively,methyl thiazolyl tetrazolium (MTT) assay and flow cytometry were carried out to detect cell proliferation and apoptosis,respectively.Results TCTP was overexpressed in SCC tissue specimens,and the expression level was positively correlated with the histologic grading of SCC (P ＜ 0.05).Western blot showed that TCTP was expressed in both A431 and SCL-1 cells,and the expression was relatively high in A431 cells.The transfection efficiency of siRNAs varied from 90％ to 95％.A decrease in the expression of TPT1 mRNA and TCTP was induced by the siRNAs in A375 cells (all P ＜ 0.05).Conclusion The downregulation of TCTP expression may increase the apoptosis in and suppress the proliferation of A431 cells.

Objective: To evaluate the concordance of PD-L1 expression in various tissues using antibodies 28-8 and SP263 on their respective detection platforms. Methods: Three hundred seventy four specimens of surgical resection of pulmonary diseases in the First Affiliated Hospital of Nanjing Medical University from January 1, 2012 to January 31, 2017 were collected. Totally 374 cases were tested for PD-L1 expression using the two antibodies, 28-8 and SP263, by respective detection platforms (Dako and Ventana). Finally, 336 cases were used for further evaluation, and the results were statistically analyzed for concordance. Results: For non-small cell lung carcinoma (NSCLC), the positive rate of PD-L1 was 57.5% (177/308) using SP263, and 57.5% (177/308) using 28-8 antibody. The correlation coefficient was 0.97 (P<0.01). The positive rate of both benign lung diseases and paracancerous tissues was about 10.7% (3/28), and the positive concordance rate was 100.0%. The distribution of both antibodies was also relatively consistent. Conclusions The expression levels of 28-8 and SP263 antibodies in NSCLC and other tissues are relatively consistent, suggesting both antibodies may be complementary and substitute for each other, which may be useful in guiding clinical management.

Objective:To evaluate and compare the safety, efficacy, stability and predictability of laser-assisted subepithelial keratomileusis (LASEK) with femtosecond laser assisted in situ keratomileusis (FS-LASIK) for high myopic eyes.Methods:A non-randomized controlled clinical study was performed.The clinical data of 141 eyes of 75 patients who received LASEK or FS-LASIK for high myopia in Shandong Eye Hospital from January 2013 to December 2016 with complete medical data during 1-year following-up.The 56 eyes with the preoperative diopter of (-8.29±1.64)D received LASEK (LASEK group), and the 85 eyes with the preoperative diopter (-7.97±1.38)D underwent FS-LASIK (FS-LASIK group). Pre- and post-operative best corrected visual acuity (BCVA) and post-operative uncorrected visual acuity (UCVA) were recorded, and the spherical equivalent was examined by subjective optometry.The efficacy index, safety index, refractive stability, predictability and complications were assessed 6 months and 12 months after surgery.Efficacy index was defined as postoperative UCVA/preoperative BCVA; safety index was postoperative BCVA/preoperative BCVA; refractive stability was the difference of spherical equivalent between postoperative 6 months and 12 months, and predictability was the percentage of the eyes with the diopter ≤±0.50 D after surgery.This study protocol was approved by the Ethic Committee of Shandong Eye Hospital (No.SDSYKYY20180130).Results:There were no significant differences in efficacy index and safety index in both LASEK group and FS-LASIK group at 6 months and 12 months after surgery (all at P>0.05). The spherical equivalent was (0.08±0.30)D and (0.10±0.38)D in the LASEK group and (0.00±0.32)D and (0.01±0.35)D in the FS-LASIK group at 6 months and 12 months after surgery, and there were no significant differences between different time points in both LASEK group and FS-LASIK group ( t=0.376, P>0.05; t=0.227, P>0.05), showing a good refractive stability.At 12 months after surgery, the percentage of the eyes with spherical equivalent within ±0.50 D was 91.1% in the LASEK group and 96.4% in the FS-LASIK group, there was no significant difference between the two groups ( χ2=1.838, P>0.05). Four eyes in the LASEK group developed corneal haze at 12 months after the operation, and the postoperative BCVA was less than the preoperative BCVA. Conclusions:Both LASEK and FS-LASIK are safe, effective, stable and predictable for the correction of high myopic eyes.Corneal haze after LASEK is the main reason for the loss of BCVA.

Objective:To analyze and compare the corneal higher order aberration (HOA) after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).Methods:A non-randomized controlled study was conducted.Sixty myopic patients (60 eyes) who underwent FS-LASIK or SMILE correction at Shandong Eye Hospital from April 2018 to January 2020 were enrolled and the data from the right eye were collected for analysis.Thirty cases (30 eyes) who received FS-LASIK in FS-LASIK group and 30 cases (30 eyes) who received SMILE in SMILE group had a preoperative equivalent spherical diopter of (-5.36±1.11)D and (-4.93±1.03)D, respectively.The HOA of the 6-mm anterior surface, posterior surface, and whole cornea were measured before surgery and at 1, 3, 6, and 12 months after surgery using Pentacam.The root mean square values (μm) of total corneal HOA, spherical aberration, coma and trefoil were obtained.Differences in the above root mean square values at different time points were compared between the two groups.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Shandong Eye Hospital (No.SDSYKYY20180306). Written informed consent was obtained from each subject.Results:The preoperative and 1-, 3-, 6-, 12-month postoperative total HOA of the anterior corneal surface were (0.428±0.126), (0.775±0.169), (0.811±0.194), (0.759±0.214), (0.704±0.199)μm in the FS-LASIK group and (0.409±0.094), (0.656±0.148), (0.681±0.161), (0.668±0.175), (0.648±0.160)μm in the SMILE group, with a significant overall difference ( Fgroup=5.652, P=0.024; Ftime=107.169, P<0.01). Compared with SMILE group, the postoperative total HOA of anterior corneal surface and spherical aberration at different time points were increased in FS-LASIK group, showing statistically significant differences (all at P<0.05). Compared with before surgery, the postoperative total HOA of the anterior corneal surface and spherical aberration at different time points were increased in both groups, showing statistically significant differences (all at P<0.05). In the two groups, the 6- and 12-month postoperative total HOA of the anterior corneal surface were reduced in comparison with the 3-month postoperative ones of the anterior corneal surface, and the 12-month postoperative spherical aberrations of the anterior corneal surface were significantly reduced in comparison with the 1- and 3-month postoperative ones of the anterior corneal surface, showing statistically significant differences (all at P<0.05). There were significant differences in the coma and trefoil of the anterior corneal surface between before and after the operation (coma: Ftime=47.848, P<0.01; trefoil: Ftime=2.497, P=0.046). Compared with before surgery, the postoperative coma was significantly increased in the two groups (all at P<0.05). There were significant differences in total corneal HOA and spherical aberration at different postoperative time points between the two groups (total HOA: Fgroup=8.093, P=0.008; Ftime=125.019, P<0.01.spherical aberration: Fgroup=4.771, P=0.037; Ftime=34.033, P<0.01). Compared with SMILE group, the total corneal HOA and spherical aberration were significantly increased in FS-LASIK group at different postoperative time points (all at P<0.05). Compared with before surgery, postoperative total HOA of the anterior corneal surface and spherical aberration at different postoperative time points were significantly increased in both groups (all at P<0.05). In both groups, the 12-month postoperative corneal spherical aberration was significantly reduced in comparison with the 1- and 3-month postoperative ones (all at P<0.05). There was a significant difference in coma between before and after surgery ( Ftime=30.829, P<0.01). Compared with before surgery, the postoperative coma was significantly increased at different time points in both groups (all at P<0.05). Conclusions:Both FS-LASIK and SMILE increase the HOA of the anterior corneal surface and the whole cornea.Compared with FS-LASIK, SMILE introduces less HOA of the anterior corneal surface and the whole cornea as well as spherical aberrations.

OBJECTIVETo study the clinical and histopathologic features of metanephric adenoma (MA).

METHODSEight cases of recently diagnosed MA were retrieved from archival file. Immunohistochemical study was carried out. The clinical characteristics, pathologic parameters, differential diagnosis, treatment options and prognosis of MA were analyzed, with literature review.

RESULTSThe patients included 6 females and 2 males. The age of patients ranged from 12 to 70 years (mean=43.6 years). Eight cases were located in renal cortex and showed well-defined borders. Histologically, the tumor was composed of tubules lined by small basophilic cells and embedded in an edematous stroma. Papillary structures and psammoma bodies were focally seen. Immunohistochemical study showed that the tumor cells were positive for PAX2 and vimentin in all the 8 cases. WT-1 was positive in 2 cases, focal and weak in 5 cases, and negative in 1 case. CK-Pan was positive in 3 cases. CK7 staining was mostly negative, with focal and weak positivity only in 1 case. The proliferative index, as highlighted by Ki-67 staining, was less than 2% in 7 cases and focally around 5% in 1 case. The expressions of CK20, CD10, RCC, epithelial membrane antigen, CD56, synaptophysin and chromogranin A were negative. Follow-up information from 7 to 57 months was available in all patients; and none of them developed local recurrence or distant metastasis.

CONCLUSIONSThe diagnosis of MA relies primarily on thorough histologic examination and immunohistochemical study (vimentin and PAX2 positive, WT-1 focally and weakly positive in some cases, and low proliferative index). Correlation with clinical and radiologic findings would also be helpful.

Adenoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; Child ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; PAX2 Transcription Factor ; metabolism ; Tomography, X-Ray Computed ; Vimentin ; metabolism ; WT1 Proteins ; metabolism ; Wilms Tumor ; pathology ; Young Adult

Peripheral bacterial infections without impaired blood-brain barrier integrity have been attributed to the pathogenesis of Parkinson's disease (PD). Peripheral infection promotes innate immune training in microglia and exacerbates neuroinflammation. However, how changes in the peripheral environment mediate microglial training and exacerbation of infection-related PD is unknown. In this study, we demonstrate that GSDMD activation was enhanced in the spleen but not in the CNS of mice primed with low-dose LPS. GSDMD in peripheral myeloid cells promoted microglial immune training, thus exacerbating neuroinflammation and neurodegeneration during PD in an IL-1R-dependent manner. Furthermore, pharmacological inhibition of GSDMD alleviated the symptoms of PD in experimental PD models. Collectively, these findings demonstrate that GSDMD-induced pyroptosis in myeloid cells initiates neuroinflammation by regulating microglial training during infection-related PD. Based on these findings, GSDMD may serve as a therapeutic target for patients with PD.