BACKGROUND:Compared with single or composite biomolecular materials, decellulazied matrices are more biomimetic to natural ectocytic surroundings. So cel-secreted extracellular matrix is paid more and more attention in the field of tissue engineering, and the composition of these matrices are influenced by decellulezired preparation methods more or less. But there are few studies about the biological effect of different decellulazried methods on the extracellular matrix. OBJECTIVE:To investigate the composition of cel-secreted extracellular matrices in vitro by different decellularizing methods and their effects as surface modification on cytobiological reaction. METHODS:After the treatment of different decellularizing methods (freeze/thaw cycles, trypsin, weak alkal, detergents), the extracellular matrix was obtained and grouped into four kinds. The biological composition of the extracellular matrix was determined by ELISA assay. Then osteoblasts were seeded onto the four kinds of extracellular matrix surfaces. cells cultured normal y served as controls. The effect of extracellular matrix coatings on cellgrowth and differentiation were determined by MTT test and alkaline phosphatase activity test. RESULTS AND CONCLUSION:The residual components were the most in the freeze-thaw group, fol owed by the detergent and weak alkal groups, and the least in the trypsin group. Compared with the control group, the absorbance value of cells were lower in the freeze-thaw and detergent groups at days 3, 5, 7 after inoculation (both P<0.05);the alkaline phosphatase activity was lower in the trypsin group at days 5, 7 after inoculation (P<0.05), in the weak alkal group at 7 days after inoculation (P<0.05), and in the detergent group at days 3, 5, 7 after inoculation (P<0.05). Therefore, we can harvest more extracellular matrices by the freeze-thaw method, and the extracellular matrix coating synthesized by the freeze-thaw method is more helpful for cellgrowth than others.

Objective The plasma levels of fibrinogen degradation products (FDP),D-dimer(DD) and fibrinogen (Fg) in patients with rheumatoid arthritis (RA) were tested and the relationship between the upregulated coagulation system and disease activity were explored.Methods Patients were divided into the active group and the remission group and 50 patients were included in each group.Hematological variables,including FDP,DD,Fg,and disease activity parameters including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) levels and rheumatoid factor (RF) titer were measured.Two-sample t-test,linear correlation test and Chi-square test were nsed for data analysis by SPSS 11.0 software.Results Age and sex were comparable in the two groups (P＞0.05).The FDP,DD and Fg were significantly higher in patients with active disease [(12.0±8.2) μg/ml, (3.1±3.1) μg/ml, (4.6±1.4) g,/L] than those in patients with remission [(2.1±1.1) μg/ml, (0.4±0.4) μg/ml, (3.0±0.6) g/L,all P＜0.01 ].There was no difference in gender distribution in FDP and DD (P＞0.05).However,Fg was significantly higher in men than that in women (P＜0.05).FDP showed a significantly positive correlation with DAS28 (r=0.48,P＜0.01) and ESR(r=0.28,P＜0.05).DD correlated positively and significantly with ESR and DAS28 (r=0.69,0.52,all P＜0.01).Fg was significantly positively correlated with DAS28,CRP and ESR (r=0.57,0.64,0.68,all P＜0.01).FDP,DD and Fg were not correlated with RF (r=-0.07,0.06,-0.01,all P＞0.05).Conclusion FDP and DD correlate well with disease activity and may be important disease activity parameters for RA.The rank of sensitivity of FDP,CRP,DD,ESR,Fg and RF for disease activity assessment of RA presents in a declined manner.

OBJECTIVE: To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery. METHODS: APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score. RESULTS: The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (<10 points, 10-20 points, >20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality. CONCLUSION APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.
APACHE ; Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; Female ; Forecasting ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensitivity and Specificity ; Severity of Illness Index ; Young Adult

Objective To explore the demand of nursing students with different nationalities and different levels for the order-oriented nursing talent cultivation mode, so as to provide reference for the establishment of order-oriented nursing talent cultivation mode in Xinjiang. Methods From January to April 2017, a total of 801 nursing students from the School of Nursing in Xinjiang Medical University were selected by cluster sampling method and investigated with "the Demand for Order-oriented Nursing Talent Cultivation Mode Questionnaire". Results The two reasons for the nursing students in different nationalities and different levels were the good employment situation (83.77%) and the wishes of the family members (68.29%). There were statistical differences of the willingness of participating in the order-oriented nursing talent cultivation mode among the nursing students with different nationalities and educational background (P<0.01). There was no statistical difference in the choice of the order hospital between the Han nationality undergraduate students and the minority undergraduate students (P>0.05). The difference of the choice of the order hospital between Han nationality junior college students and minority junior college students was statistically significant (P<0.01). Conclusions It is urgent to establish a customized nursing talent cultivation mode based on students' employment orientation and training according to the needs of employers, so as to improve the level of medical care service in Xinjiang region.

Objective:Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods:A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023. Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds, with the denuded scalp area covered by either silicone silver ion foam dressing (Group A) or petrolatum gauze (Group B). Comparison of the following 5 parameters between the two groups: (1) Postoperative wound healing time. (2) Initial dressing change pain score was assessed using the numeric rating scale (NRS). 0 points indicated no pain, 1-3 points indicated mild pain, 4-6 points indicated moderate pain, and 7-10 points indicated severe pain. (3) Number of dressing changes. (4) Secondary trauma score, with a total score ranging from 1 to 3, where a higher score indicates more severe trauma. (5) Proportion of wounds healed to grade A (number of grade A healed cases/total number of cases in each group×100%). Depending on the data type, between-group comparisons were performed using t-test, Wilcoxon rank-sum test, or chi-square test. P<0.05 was considered a statistically significant difference. Results:A total of 60 patients, with 30 in each Group A and Group B, were included in the study. Group A was comprised of 18 males and 12 females, with an average age of (29.4±16.6) years. The burn area was (21.43±5.66)% of the total body surface area (TBSA), and the area of skin taken from the scalp was (1.80±0.61)% of TBSA. Group B was comprised of 20 males and 10 females, with an average age of (30.2±16.2) years. The burn area was (21.37±5.67)% of TBSA, and the area of skin taken from the scalp was (1.78±0.63)% of TBSA. No statistically significant differences were observed in gender distribution, age, burn area, and scalp area between the two groups( P>0.05). The wound healing time in the denuded scalp area was shorter in Group A than in Group B [(5.97±0.41) days vs. (6.93±0.58) days, t=-7.40, P<0.001]. The initial NRS pain score during dressing change was lower in Group A than in Group B [3.0 (2.0, 4.0) points vs. 5.5 (4.0, 6.0) points, Z=-4.82, P<0.001]. Group A had fewer frequency of dressing changes compared to Group B [2 (2, 2) vs. 4 (3, 5), Z=-6.64, P<0.001]. The secondary injury score was lower in Group A than in Group B [1 (1, 1) points vs. 3 (3, 3) points, Z=-7.08, P<0.001]. The proportion of grade A healing was 96.7% (29/30) in Group A and 90.0% (27/30) in Group B, with no statistically significant difference between the two groups ( χ2=0.27, P=0.605). Conclusion:The application of silicone silver ion foam dressing to cover the denuded scalp area of burn patients significantly improves therapeutic efficacy compared to petrolatum gauze. It can shorten wound healing time, reduce the frequency of dressing changes, alleviate pain, minimize the occurrence of secondary injuries, and enhance patient comfort.

Objective:Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods:A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023. Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds, with the denuded scalp area covered by either silicone silver ion foam dressing (Group A) or petrolatum gauze (Group B). Comparison of the following 5 parameters between the two groups: (1) Postoperative wound healing time. (2) Initial dressing change pain score was assessed using the numeric rating scale (NRS). 0 points indicated no pain, 1-3 points indicated mild pain, 4-6 points indicated moderate pain, and 7-10 points indicated severe pain. (3) Number of dressing changes. (4) Secondary trauma score, with a total score ranging from 1 to 3, where a higher score indicates more severe trauma. (5) Proportion of wounds healed to grade A (number of grade A healed cases/total number of cases in each group×100%). Depending on the data type, between-group comparisons were performed using t-test, Wilcoxon rank-sum test, or chi-square test. P<0.05 was considered a statistically significant difference. Results:A total of 60 patients, with 30 in each Group A and Group B, were included in the study. Group A was comprised of 18 males and 12 females, with an average age of (29.4±16.6) years. The burn area was (21.43±5.66)% of the total body surface area (TBSA), and the area of skin taken from the scalp was (1.80±0.61)% of TBSA. Group B was comprised of 20 males and 10 females, with an average age of (30.2±16.2) years. The burn area was (21.37±5.67)% of TBSA, and the area of skin taken from the scalp was (1.78±0.63)% of TBSA. No statistically significant differences were observed in gender distribution, age, burn area, and scalp area between the two groups( P>0.05). The wound healing time in the denuded scalp area was shorter in Group A than in Group B [(5.97±0.41) days vs. (6.93±0.58) days, t=-7.40, P<0.001]. The initial NRS pain score during dressing change was lower in Group A than in Group B [3.0 (2.0, 4.0) points vs. 5.5 (4.0, 6.0) points, Z=-4.82, P<0.001]. Group A had fewer frequency of dressing changes compared to Group B [2 (2, 2) vs. 4 (3, 5), Z=-6.64, P<0.001]. The secondary injury score was lower in Group A than in Group B [1 (1, 1) points vs. 3 (3, 3) points, Z=-7.08, P<0.001]. The proportion of grade A healing was 96.7% (29/30) in Group A and 90.0% (27/30) in Group B, with no statistically significant difference between the two groups ( χ2=0.27, P=0.605). Conclusion:The application of silicone silver ion foam dressing to cover the denuded scalp area of burn patients significantly improves therapeutic efficacy compared to petrolatum gauze. It can shorten wound healing time, reduce the frequency of dressing changes, alleviate pain, minimize the occurrence of secondary injuries, and enhance patient comfort.

Objective:To explore the application of meticulous nursing based on enhanced recovery after surgery (ERAS) in patients after meningioma surgery.Methods:From June 2020 to February 2021, convenience sampling was used to select 124 meningioma patients with surgery in the Neurosurgery Department of Henan Cancer Hospital as the research object. The patients were divided into the observation group and the control group, with 62 cases in each group. The control group was given routine nursing during the perioperative period of neurosurgery, and the observation group conducted meticulous nursing based on ERAS on the basis of the control group. This study compared the early postoperative ambulation between the two groups of meningioma patients, including the time to get out of bed for the first time, the time of first ambulation, and the distance to first ambulation. The Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) and the Barthel Index for activities of daily living (ADL) were used to compare the anxiety, depression and ADL of the two groups of meningioma patients before and after nursing care. The incidence of complications within 7 days after the surgery of the two groups of meningioma patients was compared.Results:The time to get out of bed for the first time, time of first ambulation, and the distance to first ambulation in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.01) . The ADL scores of patients of the observation group after nursing were higher than those of the control group, and the scores of SAS and SDS were lower than those of the control group, and the differences were statistically significant ( P<0.01) . The incidence of complications in the observation group within 7 days after surgery was 9.7% (6/62) , which was lower than 27.4% (17/62) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:ERAS-based meticulous nursing can improve early postoperative ambulation in patients with meningioma, help relieve patients' anxiety and depression, increase patients' ADL, and reduce postoperative complications, which is worthy of clinical application.

ObjectiveTo compare the therapeutic effects of carvedilol alone and carvedilol combined with endoscopic variceal ligation （EVL） in the prevention of re-bleeding from gastroesophageal varices， and to provide strategies for clinical treatment. MethodsWe retrospectively included 178 patients who had received carvedilol alone or carvedilol plus EVL to prevent gastroesophageal variceal re-hemorrhage from October 2010 to June 2023. They were divided into carvedilol alone group （47 cases） and carvedilol+EVL group （131 cases）. Between-group comparisons were conducted using the paired t test for normally distributed continuous data， the Mann-Whitney U test for non-normally distributed continuous data， and the chi-square test for categorical data. A Cox proportional hazards model was employed for univariable and multi-variable analyses. The cumulative incidence rates of re-bleeding and mortality were estimated using the Kaplan-Meier method. The baseline characteristics of the two groups were matched through propensity score matching （PSM） to reduce selection bias and enhance the credibility of causal inference. ResultsThe re-bleeding rate of the carvedilol+EVL group was significantly lower than that of the carvedilol alone group （10-year cumulative incidence： 29.8% vs 36.2%， hazard ratio ［HR］=0.505， 95% confidence interval ［CI］： 0.292‍ ‍—‍ ‍0.847， P=0.015）. There was no significant difference in liver-related mortality （10-year cumulative incidence： 21.3% vs 21.4%， HR=0.799， 95%CI： 0.406‍ ‍—‍ ‍1.578， P=0.518）. The results were stable with PSM analysis. The Cox regression analysis revealed that creatinine was an independent risk factor affecting re-bleeding （HR=1.004， 95%CI： 1.001‍ ‍—‍ ‍1.008， P=0.011） and liver-related mortality （HR=1.004， 95%CI： 1.001‍ ‍—‍ ‍1.007， P=0.019）. ConclusionCarvedilol combined with EVL is better than carvedilol alone in the prevention of gastroesophageal variceal re-bleeding.

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.