To identify the best suture techniques for the tendon repair, the biomechanical properties of tendons sutured by different methods were dynamically examined. 140 chickens were divided into 2 groups equally: group A and group B. The tendon of the right side was subjected to injury-repair process, and the tendons of the left sides served as controls in both groups. In group A, "figure-of-8" suture, modified Kessler suture and Bunnell suture were used for the 2nd to 4th paws respectively, while in group B, Kleinert suture, Tsuge suture and Ikuta suture were used. On the day 0, 3, 7, 14, 21, 28, 42 after operation, 10 animals were sacrificed and the flexor tendons of both sides were harvested for strength test. The results showed that the initial strength of the repaired tendons and the strength after 6 weeks following tendon cut were far below those of intact tendons, irrespective of suture techniques used. With the 6 techniques, the P(max) of tendons repaired by Tsuge suture was increased continually, reaching the highest value on the 42nd day. The P(max) of tendons sutured by the modified Kessler suture was slightly lower than that by Tsuge suture, but it was increased steadily in healing. The tendons repaired by figure-of-8 suture yielded the lowest P(max). It was concluded that Tsuge suture and modified Kessler suture were the best techniques for tendon repair.
Biomechanics ; Chickens ; Suture Techniques ; Tendon Injuries/*surgery ; Tendons/*surgery ; Tensile Strength ; Wound Healing

Objective To investigate the relationship between the genotype and phenotype of erythropoietic protoporphyria (EPP) in a family.Methods Venous blood samples were collected from two patients with EPP as well as their asymptomatic parents and grandmother.PCR was performed to assess the mutation of FECH gene,and real-time quantitative PCR to detect the expression of FECH gene.Results A mutation IVS3 + 1G ＞ A was detected in the two patients and their mother.Haplotype analysis showed that both patients with photosensitivity carried the wild-type low-expressed allele IVS3-48C,while their mother,the asymptomatic carrier,harbored the normal allele IVS3-48T.As real-time PCR showed,the expression intensity of FECH gene gradually increased from patients,asymptomatic patients to normal individuals.Conclusion The difference in expression intensity of FECH gene may contribute to the variability in clinical presentation of EPP.

Objective To study the histological structures of retinotectal system in zebrafish. Methods The structures of tectum and retina were examined histologically and the total number and diameter of the optic nerve fibers were studied quantitatively. Results The retina includes 10 layers, and the tectum is differentiated into 6 layers. The mean thickness of the tectum is about 219\^7?8\^3?m. The optic nerve of zebrafish has approximately 78?960 myelinated fibers. The mean of the outer diameter (D) of the myelinated fibers was 0\^50?0\^18?m, while the mean of the inner diameter (d) is 0\^35?0\^14?m. Virtually all axons within optic nerves are myelinated.Conclusion\ The results not only accord with the typical pattern of retina and tectum in vertebrates, but also reflect the characteristic of diurnal activity and good vision in zebrafish.\;[

Objective To analyze the value of CT in diagnosing and following-up gastrointestinal stromal tumors(GIST).Methods 117patients with CT examination and histological diagnosis of GIST were retrospectively reviewed.Results 117 patients had 118 GIST.Thelocations of primary tumor were as follows: stomach(n=56),small intestine(n=40),esophagus(n=6),colorectum(n=6),mesentery(n=3),retroperitoneum(n=2) and indefinite origin(n=5).Size of tumor was 1.7~18 cm.Tumors(5 cm) often demonstrated lobulated shape with central low attenuation area and heterogeneous enhancement.There were 17 tumors with bubble,13 with scattered calcifications,12 with metastases of liver.With following-up,23 of 37 were developed local recurrence or hepatic metastases.Conclusion CT is aneffective and useful imaging modality in the diagnosis and follow-up gastrointestinal stromal tumors.

Objective To discuss the diagnostic value of CT and MRI for primary anorectal malignant melanoma(AMM).Methods 5 patients(2 males and 3 females)with AMM confirmed pathologically were analyzed retrospectively,which were examined by CT(n=4)and 1.5T MRI(n=1).Results AMM presented as bulky intraluminal fungating masses without intestinal obstruction(n=4)and irregular rectal wall thickening(n=1).2 cases had perirectal fat infiltration and extended to the presacral space in one case,4 cases had perirectal enlarged lymph nodes and larger than 3 cm in diameter in one case.Nonenhanced CT showed a hypodense lesion and contrast-enhanced CT showed slight enhancement(n=1)and mild enhancement(n=3).The tumor scanned by MRI depicted high intensity on T1WI and low intensity on T2WI,so did the enlarged lymph nodes and bone metastasis.Fat-saturation T1WI significantly improved the extention of tumor and detection of metastasis.Conclusion Bulky intraluminal fungating masses without intestinal obstruction,perirectal fat infiltration and enlarged lymph nodes may be helpful to diagnose AMM.MRI is especially useful in differentiating melanotic AMM from other rectal tumors.

Objective To investigate the establishment and application effect of Evaluation Form for Cancer Pain Nursing Quality Control. Methods Nursing quality control team was founded on account of the leadership of the superintendent of nursing department and the head nurse from department of pain clinic. The team consisted of eight nurses containing the head nurse from model ward of the standardized treatment for cancer pain and nurses from department of pain clinic. According to the criteria and content of on- site assessment of cancer pain standardized treatment demonstration unit, indexes for cancer pain nursing quality was made, combining with the management practice of cancer pain nursing. The quality indexes was divided into five one- class indexes which had a total score of 100 and 20 for each including pain assessment, cancer pain treatment, patient education, nursing ability and others. Each one- class index followed with two - level index. And the table was applied to the cancer pain standardized treatment demonstration unit. Results After application of the Evaluation Form for Cancer Pain Nursing Quality Control, the following items were improved compared with those before application: accuracy of pain assessment [97.22%(70/72)vs.90.28%(65/72)], correctness of nursing record [98.61%(71/72)vs.88.89%(64/72)], satisfactory rate of pain control [97.22%(70/72)vs.84.72%(61/72)], accurate usage rate of cancer drugs [100.00%(72/72)vs.88.89%(64/72)] , understanding rate of health knowledge of patients and their family members[100.00%(72/72)vs.80.56%(58/72)], satisfactory degree of patients and their family members with nurses [100.00%(72/72)vs. 88.89%(64/72)], χ2=4.71, 8.87, 10.86, 8.87, 18.00, 8.87, P<0.05 or 0.01. Conclusions Application of Evaluation Form for Cancer Pain Nursing Quality Control in management of cancer pain can improve the nursing quality of cancer patients.

Objective To explore the mechanism of azithromycin (AZM) for inhibiting the proliferation of rat airway smooth muscle cells (ASMCs).Methods Thirty Sprague-Dawley (SD) rats were divided into the control group,asthma model group and AZM group.The rat model of asthma was established by ovalbumin (OVA) sensitization and stimulation in vitro.The airway related parameters of rat lung tissue were determined by using the medical image analysis system.Primary passage ASMCs were isolated and cultured using the tissue-sticking method,and the vascular endothelial growth factor (VEGF) overexpression vector or tumor necrosis factor receptor-associated factor 6 (TRAF6) overexpression vector was transfected into ASMCs in the AZM group.The protein levels of VEGF,NF-κB p65 and TRAF6 were detected by Western blotting,and the proliferation of ASMCs was evaluated by CCK-8 kit.Results AZM significantly inhibited the increase of thickness of total airway wall,thickness of inner airway wall and thickness of airway smooth muscle layer in asthma rats (P<0.05),also significantly inhibited the proliferation of ASMCs in the asthma model group (P<0.05).AZM significantly inhibited the protein expression of VEGF and NF-κB p65 induced by asthma (P<0.05),and the overexpression of VEGF significantly reduced the inhibiting effects of AZM on proliferation of ASMCs (P<0.05).AZM significantly inhibited the high expression of TRAF6 induced by asthma (P<0.05),and the overexpression of TRAF6 significantly reduced the inhibiting effects of AZM on expression of VEGF and NF-κB p65 as well as proliferation of ASMCs (P<0.05).Conclusion AZM can suppress the proliferation of ASMCs,its partial mechanism may be realized through inhibiting TRAF6/NF-κB/VEGF signaling pathway.

To identify the best suture techniques for the tendon repair, the biomechanical properties of tendons sutured by different methods were dynamically examined. 140 chickens were divided into 2 groups equally: group A and group B. The tendon of the right side was subjected to injury-repair process, and the tendons of the left sides served as controls in both groups. In group A, "figure-of8" suture, modified Kessler suture and Bunnell suture were used for the 2nd to 4th paws respectively, while in group B, Kleinert suture, Tsuge suture and Ikuta suture were used. On the day 0, 3,7, 14, 21, 28, 42 after operation, 10 animals were sacrificed and the flexor tendons of both sides were harvested for strength test. The results showed that the initial strength of the repaired tendons and the strength after 6 weeks following tendon cut were far below those of intact tendons, irrespective of suture techniques used. With the 6 techniques, the Pmax of tendons repaired by Tsuge suture was increased continually, reaching the highest value on the 42nd day. The Pmax of tendons sutured by the modified Kessler suture was slightly lower than that by Tsuge suture, but it was increased steadily in healing. The tendons repaired by figure-of-8 suture yielded the lowest Pmax. It was concluded that Tsuge suture and modified Kessler suture were the best techniques for tendon repair.

Objective To discuss the effect of intra-operative and post-operative hyperthermic intraperitoneal lavage chemotherapy for Ⅲb and IV gastric cancer on post-operative peritoneal metastasis and survival rate.Methods The clinical data of 31 cases of gastric cancer(control group)who underwent operation only and 50 cases(chemotherapy group)who receved operation combined with intra-operative and post-operative hyperthermic intra-peritoneal lavage chemotherapy were comparatively studied.Results The survival rate of control group after 2 years and 3 years was lower than that of the chemotherapy group,and the intraperitoneal recurrence raue of cootrol group after 2 years and 3 years was higher than that of chemotherapy group.Conclusions Intra-operative and post-operative hyperthermic intraperitoneal lavage chemotherapy for gastric cancer has important significance in prevention and treatment of peritoneal metastasis and can improve survival rate.

Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.