Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.

ObjectiveTo discuss the impact of conflict psychological stress on rats'sleep time and sleep phrase.Methods20 Wistar male rats were randomly divided into vehicle group and model group,10 in each group.The improved experiment of Vogel drinking water conflict was used to establish the model of conflict psychological stress in rats and monitoring the changes of rats'weight and concentration of corticosterone (CORT) in serum after a week.After one week,the 12 h EEG and EMG of rats were traced by the polygraph in order to clarify the effect of conflict psychological stress on rats′ sleep time and sleep phrase.ResultsAfter one week,compared with vehicle group the weight of model group decreased significantly ( t =2.87,P ＜ 0.05 ),the concentration of CORT in serum raised significantly( t=5.19,P ＜ 0.05 ).A week later,compared the vehicle group,total sleep time( TST),light sleep,slow wave sleep(SWS) and rapid eye movement sleep (REM) time in model group rats ( (337.8 ±84.2)min,( 169 ±49.2) min,( 136.9 ±40.8)min,(33.1 ± 10.1 ) min for vehicle group; ( 155.4 ±16.7 ) min,( 111.6 ± 16.4 ) min,( 30.6 ± 4.9 ) min,( 12.6 ± 3.3 ) min for model group) were significantly reduced ( t =6.75,2.43,5.51,5.78,P ＜ 0.05 ),and the proportion of lightsleep increased ( (49.6 ± 3.4 ) ％,( 71.7 ±5.4)％ ) ( t =6.90,P＜0.05),the proportion of SWS decreased( (40.3 ± 10.9)％,( 19.8 ±3.2)％ ) ( t=6.74,P ＜ 0.05 ) ;but no significant change in the proportion of REM ( t =1.57,P＞ 0.05 ).Rats,sleep-wake rhythm figure indicated that the rats'sleep duration reduced and the number of awakening increased ; sleep tended to be fragmentation.ConclusionsConflict psychological stress lead to hypothalamus-pituitary-adrenal axis hyperactivity,weight loss,and the rhythm of sleep and sleep phase change in rats.

ObjectiveTo explore the effects of comprehensive rehabilitation on life quality of patients with stroke in recovery phase.Methods83 patients with stroke in recovery phase (over 3 months) accepted comprehensive rehabilitation. Their extremity motor function and activity of daily living (ADL) were compared before and after rehabilitation.ResultsThere were statistically significant difference on Brunnstrom scores and ADL scores before and after rehabilitation(P<0.01).ConclusionComprehensive rehabilitation can improve motor function and quality of life in post-stroke patients.

BACKGROUND:Pretreatment is a dominant way to increase the histocompatibility of biomaterials,but many pretreatments are not satisfactory due to some reactions,such as calcification,cytotoxic reaction and reducing the tension resistance.OBJECTIVE:To investigate the effect of immunogenicity,scaffold tension and cell growth factor on the non-pretreated scaffold biomaterials,and to prepare the homograft decellularized scaffolds.DESIGN:Contrast observation for the histomorphology.SETTING:The experiments were carried out in the Department of General Surgery,Affiliated Hospital of Nantong University from June 2006 to March 2007.MATERIALS:Wistar rats of SPF grade were adopted in this study.Sodium dodecyl sulfate from BioteehGrade Company(U.S.A.);basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) from Peprotech Company(UK);dynamometer from Suzhou Electrical Element First Factory (China).METHODS:The vena cava inferior from rats were selected as experimental materials,we decellularized the epithelial cells from vein according to the improved Booth's methods with low osmotic Tris buffer containing sodium dodecyl sulplate,and then reserved the extracellular matrix.After fixing,the decellularized scaffold was stained by hematoxylin and eosin,the collagen fibers were observed and photographed by light microscope and scanning electron microscope.Changes of the intensity of the scaffolds were measured before and after decellularization.The deceilularized scaffolds were transplanted subcutaneously at homogeneity rats to observe whether the scaffolds had induced immunological rejection.In combination with bFGF and/or VEGF,the scaffolds were transplanted subcutaneously at homogeneity rats and took out two weeks later,in order to exam the new vessels in the scaffolds by immunohistochemistry.Dynamometer was applied to compare the change of the intensity of the scaffolds before and after transplantation.MAIN OUTCOME MEASURES:Change of the intensity of the scaffolds after decellularization and transplantation.Formation of new vessels in scaffolds.Local rejection of the scaffold subcutaneously transplanted into rats.RESULTS:The endothelial cells of the vein were completely removed when incubated with Tris buffer containing 0.03% sodium dodecyl sulfate for 48 hours.Results of hematoxylin and eosin staining,light microscope and scanning electron microscope showed that,the main components of extracellular matrix (collagen fiber) were reserved.There was no significant difference in the morphological structure and the intensity of collagenous scaffolds before and after decellalarization (P＞0.05).There was no apparent reject reaction at the embedded site,local incisions healed well.New vessels could be observed in the scaffolds two weeks later.There was no significant difference in the intensity of collagenons scaffolds before and after inoculation (P＞0.05).CONCLUSION:The low osmotic Tris buffer containing 0.03% sodium dodecyl sulfate is suitable for decellularizing the vein.The homograft collagenous scaffolds exhibit no rejection after transplantation,and the intensity of the scaffolds does not descend.VEGF and bFGF can improve the growth of new vessels in the decellularized scaffolds,and have a synergistic effect.

Objective To evaluate the correlation between MRI and X-Ray discography findings and pain response at provocative discography in patients with discogenic back pain. Methods Two hundred and fifty-six lumbar intervertebral discs in 93 patients who underwent MRI and X-Ray discography were included in this study. MR images were retrospectively evaluated regarding disc degeneration, endplate abnormalities and high intensity zone. Disc degeneration was graded according to the modified criteria of Pearce, et el. Evaluation of disc morphology was performed with X-Ray discography by using the classification of Adams, et al. Endplates and adjacent bone marrow abnormalities were classified according to Modic,et al. During discography concordant pain was regarded as positive, whereas discordant pain and no pain were regarded as negative. The data were analyzed using the Chi-squnre test. Results There were 116 discs with concordant pain and 140 discs with discordant pain or no pain. Of 256 discs on discography, 17 discs were type Ⅰ17(6.6%),type Ⅱ were 25(9.8%),type Ⅲ were 91(35.5%), type Ⅳ were 77(30.1%) and type Ⅴ were 46(18.0% ). On MR images, discs of grade Ⅰ were 23 (9.0%) ,grade Ⅱ were 34(13.3%), grade Ⅲ were 84(32.8%), grade Ⅳ were 85 (33.2%) and grade Ⅴ were 30(11.7%). There was positive correlation between Pearce graded of MRI and classification of Adams of discography (r=0.62, X2 =160.87,P <0.01).In 123 discs of type Ⅳ to type Ⅴ on discography, 104 discs were with concordant pain. There was positive correlation between type Ⅳ-Ⅴ and concordant pain( r=0.60, X2 = 144.08, P < 0.01). In 115 discs of Ⅳ-Ⅴ grade degeneration, 99 discs presented with concordant pain. There was positive correlation between Ⅳ-Ⅴ grade disc degeneration and concordant作者单位:510120 广州,中山大学附属第二医院放射科 pain(r = 0.59, X2 = 137.11, P <0.01 ). In 60 discs with high intensity zone(HIZ), 52 discs presented with concordant pain. There was positive correlation between HIZ and concordant pain ( r=0.41, X2= 51.93, P <0.01 ). In 58 discs with endplate degeneration, 51 presented with concordant pain. There was positive correlation between Modic degeneration and concordant pain ( r = 0.41, X2= 52.76, P < 0.01 ). Conclusion In patients with chronic low back pain, MR imaging may present moderate to severe disc degeneration, high intensity zone, endplates and adjacent bone marrow abnormalities. MR findings with concordant pain can raise the diagnostic possibility of discogenic lumbar pain. Typical discography findings, fissured or ruptured disc, with concordant pain are important diagnostic evidence for discogenic lumbar pain.

Objectives To study the serum level and the clinical significance of anti-ribosomal protein P0 antibody in discoid lupus erythematosus(DLE) and systemic lupus erythematosus(SLE) patients. Methods Serum anti-RPLP0 IgG antibody of 18 DLE patients and 23 SLE patients were tested by Enzyme-Linked Immunosorbent Assay (ELISA). Direct immunofluoreseence (DIF) was used to examined the immunoreaetants from skin lesion. Serum antibody and complement C3 were detected by conventional methods. Results Anti-ribosomal P0 antibody was higher in SLE patients (1.23 ± 0.62. mean ± SD) than in patients with DLE (0.53 ± 0.18, P<0.001) and healthy controls (0.72 ± 0.16, P<0.001), but was no difference in the later two groups (P=0.5). Among SLE patients , anti-ribosomal P0 protein antibody were much higher in patients with arthritis , nephritis and specific skin lesion than in those without these disorders (P<0.05). Anti-ribosomal P0 antibody was not associated with SLEDAI and CLASI(P=0.012). Conclusions There is no difference of serum anti-ribosomal P0 antibodies between healthy controls and DLE patients. SLE patients have higher level of serum anti-ribosomal P0 antibody , specially in those with specific skin lesion.

BACKGROUND:Neural stem cel s with self-proliferation and differentiation potential are the ideal seed cel s for central nervous tissue engineering. Although col agen and silk fibroin as biological scaffold materials have been widely used, both of them used alone have certain shortcomings. Is it possible to combine the two materials to build a novel neural tissue-engineered scaffold? What is the effect of this novel scaffold on the growth and differentiation of neural stem cel s? OBJECTIVE:To observe the growth and differentiation of neural stem cel s seeded onto the novel composite scaffold. METHODS:The rat embryonic neural stem cells were inoculated onto new composite scaffolds, and then, their growth and differentiation were observed by light microscopy and scanning electron microscopy. Neural stem cells were cultured in conventional suspension culture as control group. Cell counting kit-8 assay was used to detect viability of neural stem cells in the two groups. Three-dimensional composite scaffolds carrying neural stem cells were slic ed into paraffin sections to observe the growth and differentiation of neural stem cells by hematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION:Neural stem cel s cultured on the new composite scaffold grew and differentiated wel , and interconnected synapses were observed. Cel counting kit-8 assay showed that neural stem cel s on the scaffold grew wel , and the cel viability was significantly higher in the composite scaffold group than that in the control group (P<0.05). Hematoxylin-eosin staining and immunofluorescence staining of paraffin sections further provided evidence for good growth and differentiation of neural stem cel s on the scaffold. These results indicate that the novel composite scaffold with good biocompatibility benefits the growth and differentiation of neural stem cel s, promising a favorable application prospect.

Objective To evaluate the alterations of thromboxane (TXB_2)、 prostacyclin (PGI_2)in murine acute pancreatitis (AP) and the therapeutic effect of calcium channel bocker-verapamil. MethodsA rat AP model was established to observe the alterations of plasma levels of TXB_2, 6-keto-PGF_ 1? and TXB_2/6-keto-PGF_ 1? ratio and the effect of verapamil. Pancreatic histology was examined by light and electron microscopy. ResultsAt 16 and 24 hours after induction of AP, the plasma levels of TXB_2[(1112?235)pg/ml、(1265?162)pg/ml] and TXB_2/6-keto-PGF_ 1? ratio(9.9?0.9,10.2?1.3)increased significantly. With varapamil therapy, the plasma levels of TXB_2[(671?102)pg/ml、(697?93)pg/ml] and TXB_2/6-keto-PGF_ 1? ratio (6.9?2.2)、(6.4?0.7) were dramatically lower than those in control group (P

BACKGROUND: Seed cell exerting its function is required to depend on the extracellular matrix in tissue engineering, so that biocompatible material is important to be selected. OBJECTIVE: To prepare a novel composite scaffolds of chitosan/collagen/nano-hydroxyapatite (HA-CS/Col/nHAP) and to optimize the technology of tissue engineered-stents according to the circumstances of cell adhesion.METHODS: Chitosan was modified by hyaluronate acid. The structure was observed by differential scanning calorimetry and the Fourier transformed infrared spectroscopy. Three composites of HA-CS/Col/nHAP according to different ratio of chitosan and collagen solution (1: 2; 1: 1 and 2: 1) were prepared. The composite scaffolds were co-cultured with osteoblast MC3T3-E1, and the proliferation and cell growth curve were measured by CCK-8 method. RESULTS AND CONCLUSION: Hyaluronic acid and chitosan were crosslinked with amide linkage. Pore size was on the range from 50 μm to 250 μm. Porosity was increased with increased collagen level and elastic modulus, but density was reduced. Increased collagen content was beneficial for cell adhesion and proliferation on stent in the primary phase of cell co-culture. However, from day 10, no significant difference was determined among three samples. At the beginning of cell culture, cells adhered to the airspace insides the composite scaffolds. In the following days, cells grew in a colony manner, and cell-cell junction could be easily observed. These indicate that HA-CS/Col /nHAP composite scaffolds can improve the adhesion and proliferation of osteoblast. The ratio of chitosan to collagen volume at 1: 1 was optimal.

Objective To evaluate the apparent diffusion coefficient (ADC) of parenehyma and necrosis in distinguishing among metastatic lymph nodes, lymphoma and tuberculous lymph nodes. Methods Thirty-six patients with cervical lymph nodes metastasis from the head and neck squamous cell carcinomas,19 patients with lymphoma and 23 patients with lymph nodes tuberculosis underwent diffusion-weighted imaging. The ADC values were measured and compared in parenchyma and necrosis of 177 lymph nodes confirmed by histopathology (n = 114) and clinical follow-up (n = 63). The means between two groups were compared by t-test, and one-way analysis of variance (one-way ANOVA) was used to analyze the data among three or more groups. Results The mean ADC values of parenchyma in metastatic nodes, lymphoma and tuberculous nodes were (0.93±0.16) × 10-3mm2/s, (0.64±0.13) × 10-3mm2/s and (1.01±0.11) ×10 -3 mm2/s respectively (F = 82.928, P < 0.01) ; the ADC values of necrosis in metastatic and tuberculous nodes were (2.02 ± 0. 36) × 10-3 mm2/s and (1.25 ± 0.15) × 10-3 mm2/s respectively (t = 12.045, P <0.01). An ADC value of parenchyma lower than or equal to 0.77 × 10 -3mm2/s was used as the threshold for lymphoma, with a sensitivity 83% and specificity of 89%. An ADC value of necrotic area greater than or equal to 1.60 × 103mm2/s was used as the threshold for metastatic nodes, with a sensitivity of 88% and specificity of 100%. Conclusion The ADC value of lymph nodes, especially for their internal necrotic areas, can help judge the nature of the cervical lymph nodes.