Objective:To explore the application effect of family-centered empowerment model (FCEM) in rehabilitation nursing of children with femoral shaft fractures treated by skin traction.Methods:A retrospective case-control study was conducted to analyze the clinical data of 107 children with femoral shaft fractures treated with skin traction in Anhui Children′s Hospital from April 2019 to October 2021, including 67 males and 40 females; aged 1.5-5.0 years [2.8(2.0, 3.5)years]. Fracture types included oblique fracture ( n=50), comminuted fracture ( n=26), transverse fracture ( n=14) and spiral fracture ( n=17). FCEM nursing was implemented in 55 patients (family empowerment group) and routine home rehabilitation nursing guidance was performed in 52 patients (routine nursing group). The face, legs, activity, cry, consolability (FLACC) behavioral score on admission and at days 1, 3 and 7 after skin traction, treatment compliance rate at 1 month after skin traction, complication rate at 1 month after skin traction, length of hospital stay and fracture healing time were compared between the two groups. Results:All patients were followed up for 12-18 weeks [13.4(12.7, 13.9)weeks]. There was no significant difference in FLACC behavioral score between the two groups on admission ( P>0.05). The FLACC behavioral score was (4.0±0.7)points,(3.4±0.6)points and (2.4±0.6)points in family empowerment group at days 1, 3 and 7 after skin traction, lower than (4.8±0.7)points, (3.9±0.8)points and (3.3±0.5)points in routine nursing groups (all Ρ<0.01). One month after skin traction, treatment compliance was excellent in 51 patients, good in 4, poor in 0, with treatment compliance rate of 92.7% (51/55) in family empowerment group, and was excellent in 40 patients, good in 9, poor in 3, with treatment compliance rate of 76.9% (40/52) in routine nursing group ( Ρ<0.05). The complication rate was 5.4% (3/55) in family empowerment group, lower than 21.2% (11/52) in routine nursing group ( Ρ<0.05). The length of hospital stay and fracture healing time were (15.6±0.3)days and (7.1±0.8)weeks in family empowerment group, shorter than (16.8±0.3)days and (8.2±0.4)weeks in routine nursing group (all Ρ<0.01). Conclusion:For children with femoral shaft fractures treated by skin traction, nursing using FCEM can alleviate pain, improve treatment compliance, reduce complication rate, reduce hospital stay and shorten fracture healing time.

Objective To investigate the expression of free fatty acid receptor GPR40 and evaluate the possible function of GPR40 in the adult monkey hippocampus after ischemia. Methods According to the post-ischemic adult monkey model of Yamashima, a total of 24 adult monkeys were randomly divided into 4 groups: sham-operated group (control) and post-ischemic day 4, 9, 15 (d4, d9,d15). The expression of free fatty acid receptor GPR40 was detected at the protein level by immunoblotting and immunohistochemistry in the adult monkey hippocampus. Results Immunoblotting analysis showed the expression of GPR40 was decreased in CA1 and increased in DG after ischemia (posfischemic group vs control, P＞0.05). Immunohistochemistry data revealed that the double stained cells of GPR40 and NeuN were also decreased by 50% (d15) in CA1 and had no significant changes in DG after ischemia. Interestingly, the co-labeled cells of GPR40 and GFAP were increased 2.5 folds (d4) in post-ischemic SGZ. Conclusions There is the different expression of GPR40 in adult monkey hippocampal CA1 and DG regions after ischemia. Co-labeled cells of GPR40 and GFAP are increased in post-ischemic SGZ, which indicates that polyunsaturated free fatty acid such as DHA, a ligand of GPR40, may alleviate neuronal injury in post-ischemic hippocampus.

Background The transplantation of limbal epithelial cells cultivated on amniotic membrane is a newly developed treatment for limbal stem cell deficiency. The purpose of our study was to investigate the biological characteristics of limbal epithelial cells and evaluate the effect of transplantation of cultivated human limbal epithelial cells on ocular surface reconstruction in limbal stem cell deficiency rat model. Methods Human limbal cells were isolated and cultivated in vitro. Cytokertins 3, 12, and 19 (K3, K12 and K19) and p63 were detected by immunofluorescent staining or RT-PCR. BrdU labelling test was used to identify the slow cycling cells in the cultures. Limbal stem cell deficiency was established in rat cornea by alkali burn. Two weeks after injury, the rats received transplants of human limbal stem cells cultivated on amniotic membrane carrier. The therapeutic effect was evaluated by slit lamp observation, Hemotoxin and Eosin (HE) staining and immunofluorescent staining.Results On day 7 in primary culture, p63 and K19 were strongly expressed by most cells but only a few cells expressed K3. On days 14 and 21, p63 and K19 were still expressed by a majority of cells, but the expressive intensity of p63 decreased in a number of cells, while the proportion of K3 positive cells increased slightly and some cells coexpressed p63 and K3. RT-PCR showed that gene expression of both p63 and K12 were positive in cultivated limbal cells, but in mature superficial epithelial cells, only K12 was detected. BrdU labelling test showed that most cells were labelled with BrdU after 7 days' labelling and BrdU label retaining cells were observed after chasing for 21 days with BrdU free medium. For in vivo test, slit lamp observation, HE staining and immunofluorescent staining showed that the rats receiving transplant of human limbal stem cells cultivated on amniotic membrane grew reconstructed corneas with intact epithelium, improved transparency and slight or no neovascularization. A majority of epithelial cells of the reconstructed cornea were positive to antihuman nuclear antibody and cells expressing K3 were found mainly in superfacial epithelium.Conclusions Limbal stem cells can be cultivated in vitro: the cells are characterized by high proliferation and slow cycling and identified as p63/K19 positive and K3/K12 negative. During culture, some stem cells can proliferate and differentiate into mature cornea epithelial cells. Amniotic membrane is a suitable carrier for limbal stem cells. Transplantation of human limbal stem cells cultivated on amniotic membrane can functionally reconstruct rat cornea with limbal stem cell deficiency.

Background:Pioglitazone may be beneficial in the treatment of psoriasis.However,based on the effectiveness and safety considerations,it has not been widely used.To fully evaluate the strength of evidence supporting psoriasis treatment with pioglitazone,we conducted a meta-analysis of existing published studies.Methods:PubMed,Ovid,Cochrane Library,Google Scholar,and Web of Science databases were systematically searched before February 2019.Randomized controlled trials (RCTs) of pioglitazone administration compared with placebo,administered to patients with psoriasis for at least 10 weeks,and published in English were included.Quality of the included RCTs was identified by the modified Jadad scale.The quality of evidence for each outcome was evaluated using the GRADEpro Guideline Development Tool online software.Primary outcomes were proportion of patents showing psoriasis area and severity index (PASI) score improvement (＞75％) and the mean percent change in PASI score from baseline to the end of treatment.Dichotomous data were analyzed using odds ratios (ORs) corresponding to the 95％ confidence interval (CI),whereas continuous variables,expressed as mean and standard deviation,were analyzed using the mean differences (MD) with the 95％ CI.Results:Six RCTs were analyzed.Meta-analysis showed that pioglitazone reduced the PASI scores in patients with psoriasis compared with the control group when administered at 30 mg per day (P ＜ 0.001,MD =-3.82,95％ CI =-5.70,-1.93) and at 15 mg per day (P =0.04,MD =-3.53,95％ CI =-6.86,-0.20).The PASI-75 of the pioglitazone group was significantly higher than that of the control group at 30 mg per day (P ＜ 0.001,OR =8.30,95％ CI =3.99,17.27) and at 15 mg per day (P =0.03,OR =2.96,95％ CI =1.08,8.06).No statistically significant differences in total adverse events were observed between the groups.There were no significant differences in common adverse reactions such as weight gain and elevated liver enzymes between the two pioglitazone groups.Conclusions:Use of pioglitazone in the current treatment of psoriasis is beneficial.The therapeutic effect of the daily 30 mg dose may be greater than that of the 15 mg dose per day with no significant change in the frequency of adverse reactions.

OBJECTIVETo evaluate the outcomes of patients with unresectable massive primary liver cancer (PLC) receiving three-dimensional conformal radiotherapy (3-DCRT) combined with transcatheter arterial chemoembolization (TACE).

METHODSFrom January 2001 to December 2004, 84 patients with unresectable massive PLC (tumor size> or =10 cm) received 3-DCRT combined with TACE, including 49 cases in UICC/AJCC T(3) stage and 35 cases in T(4) stages. Lymph node metastasis was found in none of the patients, and portal vein tumor thrombosis (PVTT) was detected in 30 cases. Child-Pugh grade A of liver cirrhosis was present in 64 cases and grade B in 20 cases. The mean value of GTV was 705-/+430 cm(3) (170-2099 cm(3)). Following injections of fluorouracil and hydroxycamptothecine into the target artery of the tumor, the mixture of carboplatin, mitomycin (or pirarubicin) and super-liquefactive iodized oil was injected into the target artery. Gelatin sponge was used to embolize the artery. The procedure was repeated every 1.5-2 months according to the condition of the patients, and each patient received 1-3 such procedures. 3-DCRT was performed in all the patients, who received a total dose of 53.6-/+6.6 Gy (4-6 Gy per fraction at the interval of 48 h), and 3 fractions were given every week.

RESULTSEight patients died in 3 months after 3-DCRT and were not evaluated. The total response rate (CR+PR) in these patients was 68.9% (51/74). The overall survival rates at 1, 2 and 3 years were 55.4%, 24.7% and 15.4%, respectively. T stage, GTV, PVTT and fraction size had no significant impact on the overall survival. Child-Pugh grade was found to have significant impact on the patients' survival (P=0.035, RR=2.440).

CONCLUSION3-DCRT combined with TACE has definite therapeutic effect on advanced massive PLC, and Child-Pugh grade is an independent prognostic factor in such cases.

Adult ; Aged ; Camptothecin ; administration & dosage ; analogs & derivatives ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Female ; Fluorouracil ; administration & dosage ; Humans ; Imaging, Three-Dimensional ; methods ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; Retrospective Studies ; Treatment Outcome

Objective To test and evaluate the JAK2 gene V617F mutation in patients with myeloproliferative tumors based on i-densy IS-5320 platform according to ISO15189 accreditation requirements.Methods Instrument performance verification.Selected from December 2014 to February 2017, 20 cases of JAK2 V617F mutation positive peripheral blood samples from Huashan Hospital of the Shanghai FuDan University Medical College and 20 cases of peripheral blood samples with negative JAK2V617F mutation.The Realtime PCR with TaqMan MGB probe was selected as the control method to verify and evaluate the accuracy of testing JAK 2 V617F mutation on i-densy IS-5320 platform.Whole blood samples were used to evaluate the reproducibility , cross-contamination and anti-interference ability of this platform.The ability of mutation load was verified by detecting mixtures of human erythnoleukemia cells and colorectal cancer cell HCT116 with 12 different proportions.Results I-densy IS-5320 platform and TaqMan MGB probe real-time fluorescence quantitative PCR show the same result .The within-run reproducibility and between-run reproducibility are both 100%.There is no observed contamination .High bilirubin and high triglyceride blood samples have no obvious interference on mutation detection .The mutation ratio with a load as low as 0.25%could be tested stably by i-densy IS-5320 platform.The detecting peak of melting curve can reflect the ratio of JAK2 V617F mutation to some extent.Conclusions I-densy IS-5320 can detect the mutation of JAK2 V617F gene in the whole blood directly.It has high sensitivity, accuracy and stability, and is easy to operate, and also can reflect the mutation load of JAK2 V617F, which could meet the clinical requirements for the detection of mutations.

The probable mechanism of the reduction of rat cerebral ischemic-reperfusion injury by propyl gallate was studied. Intraluminal suture middle cerebral artery occlusion model of rat was employed. Propyl gallate was injected immediately after the ischemia was happened. The activity of NF-kappaB, and the expression of COX-2 and HSP70 on the peripheral ischemia were determined by Western blotting. The expression of TNF-alpha was determined by ELISA assay. RT-PCR and immunofluorescence staining were employed to detect the transcription and expression of TLR-4. Results showed that propyl gallate could inhibit the activity of NF-kappaB in the peripheral ischemia, and reduce the expression of COX-2 and TNF-alpha. As the upstream of NF-kappaB, the transcription and expression of TLR-4 decreased, as well as HSP70, the endogenic ligand of TLR-4. As an antioxidant, propyl gallate could reduce the cerebral ischemic-reperfusion injury through inhibiting the activity of NF-kappaB and decreasing the COX-2 and TNF-alpha in the peripheral ischemia. It also could influence HSP70 and TLR-4.
Animals ; Cyclooxygenase 2 ; metabolism ; HSP70 Heat-Shock Proteins ; metabolism ; Infarction, Middle Cerebral Artery ; complications ; Male ; Propyl Gallate ; pharmacology ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; etiology ; metabolism ; Toll-Like Receptor 4 ; genetics ; metabolism ; Transcription Factor RelA ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVE: To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds. METHODS: Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0. RESULTS: (1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points. CONCLUSION TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.
Age Determination by Skeleton/standards* ; Age Factors ; Body Height ; Bone Development ; Carpal Bones/growth & development* ; Child ; Child, Preschool ; China ; Female ; Hand/growth & development* ; Humans ; Infant ; Male ; Puberty, Precocious/diagnosis* ; ROC Curve ; Sensitivity and Specificity

Objective To investigate the effect of CoCl2-induced hypoxia on the expressions of hypoxia-inducible factor-1α(HIF-lα),glucocorticoid receptor(GR)and opiomelanocortin(POMC)in AtT-20 cells.Methods AtT-20 cells were exposed to different concentrations(25,50,100,and 200 μmol/L)of CoCl2 to induce hypoxia.MTT assay was employed to assess the changes in the cell proliferation after the exposure,and real-time PCR and Western blotting were performed to detect the expressions of HIF-1α,GR and POMC genes at both the mRNA and protein levels.Results Compared with the cells in normoxic conditions,the AtT-20 cells exposed to CoCl2 treatment at 25,50,and 100 μmol/L for 24 and 48 h showed obviously enhanced cell proliferation.CoCl2 significantly increased the mRNA and protein expressions of HIF-1α,GR and POMC genes in a dose-dependent manner(P＜0.05).Conclusion CoCl2-induced hypoxia up-regulates the mRNA and protein expressions of HIF-1α,GR and POMC genes in AtT-20 cells.

Objective To explore the effect of specific antagonist of estrogen-related receptor alpha——XCT790 on tumor growth, weight, liver index(LI), spleen index(SI) and kidney index (KI) in the diffe-rent models of tumor -bearing mice.Methods The H22 ascitic and solid tumor-bearing mice models were established , then mice were ran-domized into five groups , including model group (20%DMSO), control group(cyclophosphamide:CTX 30 mg· kg -1), experimental -L,-M,-H groups(XCT790:2,4,6 mg· kg -1).The samples were obtained in 24 h after continuous intraperitoneal administration of drug or solvent to mice for 7 d.The ascitic volume and tumor weight were measured .The ratios of LI,SI,KI were calculated.Results The ascitic volume of mice in model group, control group,and experimental -L,-M,-H groups were (6.17 ±3.04),(3.28 ±1.62),(3.60 ±1.67),(4.67 ±2.57), (4.73 ±2.66 ) mL; comparing between control group , experimental -L group and model group,the differences were significant(all P<0.01).In H22 solid tumor -bearing mice, the tumor weight of mice in model group, control group, experimental -L,-M,-H groups were (2.53 ±0.39),(1.25 ±0.45),(1.27 ±0.61),(1.14 ±0.56),(1.24 ±0.39) g with significant difference com-pared with model group ( all P<0.05 ) .LI,SI and KI had no statistically significant differences in ascitic or solid tumor-bearing groups(all P>0.05 ) .Conclusion XCT790 had anti -tumor effect on H22 tumor-bearing mice without influences on ratios of liver ,spleen and kidney.