2.83 cm(left-right).The density of lymphocele was homogeneous ,with 0~15 HU(mean value,5.7HU).Adjacent organs were displaced by compression of lymphocele.Conclusion It should be diagnosed as a lymphocele if a pelvic cyst is found in postoperation of pelvic malignant tumor.

Hyperhomocysteinemia, which is an independent risk factor for atherosclerosis, may cause aberrant methylation and dysregulation of gene expression, but the characteristics of the aberrant methylation and its key links involved in its pathogenic mechanisms are still poorly understood. The effect of hyperhomocysteine on DNA methylation in vascular smooth muscle cells, its characteristics and the underlying mechanism of Hcy-induced changing in DNA methylation patterns were investigated. Clinical relevant concentrations of homocysteine was added into the cultured vascular smooth muscle cells of the Homo sapien umbilical vein for 24 h. The level of SAM and SAH was detected by HPLC. The activity of SAH Hydrolase was detected by real-time quantitative reverse transcription-PCR and Western blotting analysis. The level and patterns of DNA methylation were measured by endogenous C-5 DNA methyltransferase(C-5 MT-ase) activity and capacity of genomic DNA to accept methyl groups and methylation-dependent restriction analysis. The results indicated that an increased Hcy concentration induced elevated SAH, declined SAM and the ratio of SAM/SAH, reduced expression of SAH Hydrolase, but increased activity of C-5MT-ase. The methylation status of gDNA analyzed by methyl-accepting capacity of gDNA uncovered a demethylation process in gDNA, or homocysteine-caused hypomethylation in gDNA.With different methylation-dependent restriction endonucleases, the aberrant demethylation was found to prefer C↓CGG sequences to CpG islands. The impacts of different dosage of Hcy showed that the varied detrimental effects of Hcy could be attributed to different concentrations via different mechanisms. In mild and moderate hyperhomocysteinemia, the Hcy may primarily influence the epigenetic regulation of gene expression through the interference of transferring methyl-group metabolism, while in more higher Hcy concentration, the notorious impacts may be more directly caused via oxidative stress, apoptosis, inflammation etc.

To improve students' experimental research skills,innovative consciousness,promote the construction of functional experimental center,we established series of “comprehensive,contrivable,innovative” experiments in medical students.

Objective:To explore the effect of enhanced recovery after surgery(ERAS)-based multidisciplinary collaboration model on shortening the time of forbidden eating before receiving surgery, provide the basis for the selection of the preoperative diet prohibition scheme.Methods:From January 2017 to February 2019, a total of 384 patients who received the operation in Qingdao Municipal Hospital were analyzed retrospectively. The patients who under the traditional preoperative diet prohibition scheme were taken as the control group(156 cases) while those who under the multidisciplinary cooperation mode nursing under the concept of eras were taken as the experimental group(228 cases). The experimental group formulated the perioperative diet prohibition process according to the guidelines of eras, and the experimental group carried out the perioperative diet management for the patients according to the procedure. The difference between the two groups in the time of fasting, hunger, thirst incidence, insulin resistance, temporary stop will be observed and compared.Results:The time of fasting was (4.01±1.55) h in the experimental group and (10.12±1.57) h in the control group,there was significant difference between the two groups( t value was -1.65, P < 0.01). The incidences of thirst,hunger were 13.2%(30/228), 11.8%(27/228) in the experimental group and 89.7%(140/156), 87.2%(136/156) in the control group, there were significant differences between the two groups(χ 2 values were 220.20, 215.20, P < 0.01). The levels of insulin resistance on the first and third day after operation were 1.85 ± 0.43,1.52±0.61 in the experimental group and 1.99±0.51, 1.67±0.49 in the control group, the differences were statistically significant ( t values were -2.90, -2.56, P < 0.05).The temporary stop rate was 1.75%(4/228) in the experimental group and 7.69%(12/156) in the control group, the difference was statistically significant( χ2 value was 8.19, P<0.01). Conclusions:The ERAS-based multidisciplinary collaboration model can effectively shorten the preoperative fasting time, reduce the level of insulin resistance, reduce the incidence of hunger and thirst, and improve the rate of temporary stop and adjustment.

Objective:To investigate the inhibitory effect of curcumin on oxidative stress in BCG-infected macrophages based on the Nrf2 pathway.Methods:THP-1-derived macrophages were infected.The experiment was divided into control group,BCG group,BCG+curcumin group and BCG+curcumin+ML385 group.Cellular ROS fluorescence intensity were observed under a fluores-cence microscope;Glutathione(GSH)levels were measured by Colorimetry;Western blot was used to detect the protein expressions of Nrf2,HO-1 and NQO1;MTT was used to detect the proliferation rate of macrophages.Results:BCG infection significantly enhanced ROS fluorescence intensity,reduced cell GSH content(P<0.01),inhibited protein expressions of Nrf2,HO-1 and NQO1,at the same time inhibited cell proliferation(P<0.01);curcumin significantly weakened ROS fluorescence intensity,increased GSH level(P<0.05),promoted Nrf2,HO-1 and NQO1 protein expressions and cell proliferation(P<0.01);Nrf2 inhibitor ML385 reversed the effect of curcumin.Conclusion:Curcumin can alleviate BCG-induced oxidative stress in macrophages by increasing the expression of Nrf2 and inducing the transcription of downstream antioxidant molecules.

Objective To study the incidence and clinical significance of the herniation pits of the femoral neck.Methods 600 cases(299 men,301 women,18～82 years)were collected.The incidence,radiologic finding and clinical significance of the herniation pit of the femoral neck were analysed.Results Of 1200 hip joints in 600 cases,there was 58 cases(64 sides)(5.3%)with herniation pits of the femoral neck,including 39 men(68.7%)and 19 women(31.3%),the lesions localized in the left joint in 25 eases(39.1%),in the right joint in 27 cases(42.2%)and in bilateral joints in 6 cases(18.7%).There were a obvious significant differences on both sexes,and no significant differences on age groups.On X-ray film,the lesions appeared as a round radiolucency with thin clear sclerotic rim.Conclusion The incidence of the herniation pit of the femoral neck is 5.3%,which has a typical X-ray feature,and may indicate the femoroacetabular impingement.

Objective:To investigate the role of peroxisome proliferator-activated receptor γ (PPARγ)/CD36 signaling pathway in macrophage lipid metabolism after Mycobacterium tuberculosis ( Mtb) infection. Methods:THP-1-derived macrophages were infected with Mtb. Four groups were included in this study, which were control group, Mtb infection group, Mtb+ rosiglitazone (ROZ, PPARγ agonist) group and Mtb+ GW9662 (PPARγ antagonist) group. Western blot and RT-PCR were used to detect the expression of PPARγ in macrophages at protein and mRNA levels, respectively. The lipids in cells were detected by oil red O staining. The concentrations of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) in the supernatant of cell culture were detected by automatic biochemical analyzer. The expression of CD36 was detected by immunohistochemistry. CCK-8 was used to detect the proliferation rate of macrophages. Results:Mtb infection significantly increased the expression of PPARγ in macrophages ( P<0.001), promoted intracellular lipid aggregation and CD36 expression and decreased the levels of TC, TG, LDL-C and HDL-C in the supernatant of cell culture ( P<0.001) and cell proliferation rate ( P<0.001). PPARγ agonist significantly enhanced the intracellular lipid accumulation and CD36 expression that were induced by Mtb infection and down-regulated the lipid level in the supernatant of cell culture and cell proliferation rate, while PPARγ antagonist reversed the above effects. Conclusions:PPARγ played a role in lipid metabolism in Mtb-infected macrophages through affecting CD36 expression.

Alzheimer' s disease (AD) is a neurodegenerative disease that gradually impairs cognitive functions. Recently, there has been a conceptual shift toward AD to view the disease as a continuum. Since AD is currently incurable, effective intervention to delay or prevent pathological cognitive decline may best target the early stages of symptomatic disease, such as subjective cognitive decline (SCD), in which cognitive function remains relatively intact. Diagnostic methods for identifying AD, such as cerebrospinal fluid biomarkers and positron emission tomography, are invasive and expensive. Therefore, it is imperative to develop blood biomarkers that are sensitive, less invasive, easier to access, and more cost effective for AD diagnosis. This review aimed to summarize the current data on whether individuals with SCD differ reliably and effectively in subjective and objective performances compared to cognitively normal elderly individuals, and to find one or more convenient and accessible blood biomarkers so that researchers can identify SCD patients with preclinical AD in the population as soon as possible. Owing to the heterogeneity and complicated pathogenesis of AD, it is difficult to make reliable diagnoses using only a single blood marker. This review provides an overview of the progress achieved to date with the use of SCD blood biomarkers in patients with preclinical AD, highlighting the key areas of application and current challenges.

Objective:To construct a quality management tool index system for nursing managers based on Delphi method, and to provide content basis and quantitative standard for improving the overall quality of nursing services.Methods:A research team was established in November 2020 to form a draft of the quality management tool index system for nursing managers through semi-structured interviews and expert meetings. In December 2020, 14 experts were invited to conduct three rounds of correspondence consultation by applying Delphi method, and constructed the index system of nursing management personnel quality management tool, and revised and confirmed it.Results:After 3 rounds of consultation, the consensus reached, the recoveries were all 100.0%, the expert authority coefficient was 0.85, the coefficient of variation was 0.07-0.23, and the Kendall harmony coefficient was 0.269, 0.274, 0.249 ( P<0.01). Finally, the index system of nursing management personnel quality management tool was constructed based on Delphi method, including 3 first-level indicators, 6 second-level indicators and 42 third-level indicators. Conclusions:The establishment of the index system of quality management tools for nursing managers based on Delphi method conforms to the practical application needs of the quality management tools for nursing managers, and can guide nursing managers to better use quality management tools and improve the overall quality of nursing services.

Objective:To evaluate the influencing factors for venous thromboembolism (VTE) in patients undergoing neurosurgery, so as to provide a reference for the establishment of preventive strategies for VTE in patients undergoing neurosurgery.Methods:Literatures related to the influencing factors of VTE in patients undergoing neurosurgery were searched systematically in PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, CNKI, Wanfang Database, VIP, China Biomedical Literature Database (CBM) . The retrieval time limit was from the establishment of database to December 31, 2021. Literature quality was evaluated by 2 researchers using the JBI Evidence-based Health Care Centre Evaluation tool in Australia. RevMan 5.4 software was used for Meta-analysis.Results:A total of 23 articles were included. The results of Meta-analysis showed that age>45 years ( OR=2.27, 95% CI: 1.44-3.58, P<0.01) , male ( OR=0.88, 95% CI: 0.79-0.98, P=0.03) , high BMI ( OR=1.68, 95% CI: 0.12-3.23, P=0.03) , hypertension ( OR=2.27, 95% CI: 1.66-3.11, P<0.01) , smoking history ( OR=1.51, 95% CI: 1.14-2.02, P=0.005) , history of previous thrombosis ( OR=6.21, 95% CI: 1.50-25.70, P=0.01) , Caucasian ( OR=1.55, 95% CI: 1.26-1.89, P<0.01) , Hispanic ( OR=0.74, 95% CI: 0.58-0.94, P=0.01) , Asian ( OR=0.37, 95% CI: 0.22-0.62, P=0.01) , lower extremity weakness or paralysis ( OR=6.14, 95% CI: 2.24-16.81, P=0.000 4) , high glioma grading ( OR=1.86, 95% CI: 1.01-3.41, P=0.04) , nerve sheath tumor ( OR=7.87, 95% CI: 1.07-57.86, P=0.04) , tumor brain metastasis ( OR=1.92, 95% CI: 1. 38-2.68, P<0.01) , intraoperative supine position ( OR=1.65, 95% CI: 1.07-2.55, P=0.02) , use of dehydrating agents ( OR=2.85, 95% CI: 1.33-6.09, P<0.01) , infection ( OR=16.23, 95% CI: 7.84-33.64, P<0.01) , central venous line placement ( OR=9.69, 95% CI: 4.80-19.58, P<0.01) were the risk factors of VTE in neurosurgery patients. Conclusions:The VTE in neurosurgery patients is affected by many factors. Medical and nursing staff should identify risk factors timely, and take targeted preventive measures and reduce the incidence of VTE.