Objective To look into the experience and feels of the family caregivers of brain tumor patients undergoing surgery. Methods The phenomenological methodology was used in the study. Eighteen family caregivers nursing brain tumor patients were selected as our target. Semi-structured interviews were performed to investigate their feelings and experience during the preoperative period. Result Three topics from our study were concluded: inappropriate emotional reaction, inexperience in the disease management and insufficiency in social support. Conclusion Medical staff and institutions should provide emotional, nursing technical support and professional knowledge for the caregivers so that they can improve their adaption ability and relieve the stress.

Objective:To explore the short-term efficacy of totally laparoscopy pancreatoduodenectomy (TLPD) and open pancreatoduodenectomy (OPD) in the treatment of periampullary carcinoma.Methods:The clinical data of 50 patients with periampullary carcinoma in the First Hospital of Shanxi Medical University from June 2016 to March 2019 were retrospectively analyzed. According to the different surgical methods, the patients were divided into TLPD group (22 cases) and OPD group (28 cases). The perioperative and postoperative related indicators between the two groups were compared.Results:Both groups had successfully received the operation. The operating time in TLPD group was longer than that in OPD group, and the difference between the two groups was statistically significant [(665±213) min vs. (447±215) min, t = -0.356, P = 0.001]. The amount of intraoperative bleeding in TLPD group was less than that in OPD group, and the difference between the two groups was statistically significant [100 ml (50-325 ml) vs. 300 ml (100-500 ml), Z = -2.230, P = 0.026]. There were no significant differences in the proportion of intraoperative blood transfusion, lymph node dissection number, resected tumor diameter, postoperative diet restriction time, postoperative extubation time, postoperative hospital stay and the incidence of postoperative complication between TLPD group and OPD group (all P > 0.05). Conclusions:TLPD and OPD has a similar short-term efficacy in the treatment of periampullary carcinoma. The operating time of TLPD is longer than that of OPD, but TLPD can effectively control the intraoperative bleeding.

Objective:To investigate the effects of decorin (DCN) on the proliferation, migration and invasion of bladder cancer cells.Methods:Bladder cancer T24 cell line was used as the research object. MTT assay was used to detect the inhibitory effect of DCN at different concentrations (0, 5, 10, 20, 30, 40, 50 mg/L) on T24 cell proliferation at 24, 48, 72 and 96 h. The effects of DCN on T24 cell cycle and apoptosis were analyzed by flow cytometry. MTT assay, Transwell migration and invasion experiments were used to detect the effects of DCN on the adhesion, migration and invasion ability of T24 cells. The effects of DCN on TGF-β1 and P21 protein expression were detected by ELISA and Western blotting.Results:T24 cells were treated with 0, 5, 10, 20, 30, 40 and 50 mg/L DCN at 24, 48, 72 and 96 h, and there were statistically significant diffe-rences in cell proliferation activity ( F=168.64, P<0.001; F=165.81, P<0.001; F=291.02, P<0.001; F=148.93, P<0.001). T24 cells were treated with 0, 5, 10, 20, 30, 40 and 50 mg/L DCN for 72 h, and the cell proliferation activities were (60.71±3.03)%, (40.82±2.09)%, (37.24±1.63)%, (25.65±2.55)%, (23.00±2.67)%, (10.78±1.17)%, (11.04±0.96)%, respectively, and there was a statistically significant difference. At the concentration of 40 mg/L, the proliferation activity reached the lowest level, and the inhibitory effect on cell proliferation was the strongest. At concentrations of 40 and 50 mg/L, the cells in G 1 phase reached the peak value, while the cells in S phase reached the lowest value, and the cells in G 2 phase remained unchanged throughout the treatment process. T24 cells were treated with 0, 5, 10, 20, 30, 40 and 50 mg/L DCN for 72 h, and the apoptosis rates of cells were (12.18±1.17)%, (21.24±1.05)%, (19.80±1.20)%, (26.52±1.40)%, (30.86±1.40)%, (52.99±1.22)%, (43.04±2.16)%, respectively, and there was a statistically significant difference ( F=178.54, P<0.001). The differences between 5, 10, 20, 30, 40, 50 mg/L DCN and 0 mg/L DCN were all statistically significant (all P<0.001). When T24 cells were treated with 0, 40 mg/L DCN for 72 h, the cell adhesion rates were (37.14±1.35)% and (59.86±1.95)%, the numbers of migrated cells were 53.86±3.18 and 12.86±1.35, and there were statistically significant differences ( t=25.25, P<0.001; t=31.36, P<0.001). When DCN was applied to T24 cells for 48 h, the numbers of invasion at 0, 40 mg/L were 235.14±3.44 and 160.86±3.13, and there was a statistically significant difference ( t=2.27, P<0.001). When T24 cells were treated with 0, 5, 10, 20, 30, 40 and 50 mg/L DCN for 72 h, the relative expression levels of TGF-β1 were 85.67±3.35, 45.51±1.19, 49.93±4.15, 47.64±3.53, 46.05±3.18, 25.54±2.25, 33.44±4.05, and there was a statistically significant difference ( F=324.58, P<0.001). Compared with 0 mg/L DCN, 5, 10, 20, 30, 40 and 50 mg/L DCN could significantly inhibited the expression of TGF-β1 (all P<0.001). Compared with 0 mg/L DCN, P21 protein was upregulated 72 h after treatment with 40 mg/L DCN. Conclusion:DCN can inhibit proliferation and induce apoptosis of T24 cells in vitro, and has the effect of anti-metastasis of T24 cells.

Objective:The distribution characteristics of intrathecal drugs and the limitation of current catheterization techniques make traditional intrathecal analgesic treatment nearly useless for refractory craniofacial pain,such as trigemina neuralgia.This technical guideline aims to promote the widespread and standardize the application of intra-prepontine cisternal drug delivery via spinal puncture and catheterization. Methods:A modified Delphi approach was used to work for this guideline.On the issues related to the intra-prepontine cisternal targeted drug delivery technique,the working group consulted 10 experts from the field with 3 rounds of email feedback and 3 rounds of conference discussion. Results:For the efficacy and safety of the intra-prepontine cisternal targeted drug delivery technique,a consensus was formed on 7 topics(with an agreement rate of more than 80%),including the principles of the technique,indications and contraindications,patient preparation,surgical specifications for intra-prepontine cisternal catheter placement,analgesic dosage coordination,analgesic management,and prevention and treatment of complications. Conclusion:Utilizing the intra-prepontine cisternal drug infusion system to manage refractory craniofacial pain could provide advantages in terms of minimally invasive,secure,and effective treatment.This application can not only alleviate the suffering of individuals experiencing the prolonged pain but also support the maintenance of quality of life and dignity in their final moments,justifiing its widespread dissemination and standardized adoption in domestic and international professional fields.

Objective:To compare the effectiveness and safety of all-suture anchors and single-row suture anchors for rotator cuff repair.Methods:A prospective randomized controlled study was conducted to analyze the clinical data of 50 patients with rotator cuff tear admitted to Second Affiliated Hospital of Zhejiang University School of Medicine between July 2019 and September 2021. They were divided into two groups according to the random table: 25 patients to receive repair with single-row suture anchors (control group) and the other 25 with all-suture anchors (trial group). Visual Analogue Scale (VAS), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion were compared between the two groups before surgery, at 3 months after surgery and at the last follow-up. The rotator cuff retear rate of the two groups was evaluated according to Sugaya classification at 6 months after surgery. Breakage or anchor loosening during surgery, healing of incision and presence of infections or neurological complications after surgery, and change of the anchor position and periosteal reaction at the insertion site at 3 and 6 months after surgery were observed in the two groups.Results:A total of 50 patients with rotator cuff tear were involved in this study, including 17 males and 33 females, aged 40-73 years [(59.1±10.3)years]. All patients were followed up for 6-9 months [(6.7±1.0)months]. The differences in VAS, UCLA shoulder score, ASES score, and shoulder range of motion between the two groups were statistically insignificant before surgery (all P>0.05). The VAS at 3 months after surgery and at the last follow-up in the control group was 2.0 (2.0, 4.0)points and 2.0 (0.0, 2.0)points, respectively, with no statistical differences from 2.0 (2.0, 2.0)points and 2.0 (0.0, 2.0)points in the trial group (all P>0.05). In the control group, the UCLA shoulder score and ASES score at 3 months after surgery and the ASES score at the last follow-up were (25.1±4.5)points, 78.8 (71.6, 85.8)points and 85.8 (85.8, 93.0)points, respectively, with no statistical differences from (26.8±4.7)points, 85.8 (82.3, 85.8)points, and 92.8 (85.8, 100.0)points in the trial group (all P>0.05). At the last follow-up, the UCLA shoulder score of the control group was (29.2±3.9)points, which was lower than that of the trial group [(31.6±2.4)points] ( P<0.05). The differences in shoulder motion between the two groups at 3 months after surgery and at the last follow-up were not statistically significant (all P>0.05). The VAS, UCLA shoulder score, and ASES score at 3 months after surgery and at the last followup in both groups were significantly improved compared to their preoperative values (all P<0.05); further improvements were observed at the last follow-up compared with those at 3 months after surgery (all P<0.05). The rotator cuff retear rate at 6 months after surgery was 16.7% (4/24) in the control group, not statistically different from 4.3% (1/23) in the trial group ( P>0.05). There were no incidences of anchor loosening or breakage during surgery. All incisions were healed after surgery, with no infections or neurological complications. No grades II to III periosteal reactions at the anchor insertion sites were observed in either group at 3, 6 months after surgery. The percentage of patients with grade 0 periosteal reaction at the anchor insertion site at 3 months after surgery was 4.2% (1/24) in the control group, significantly lower than 30.4% (7/23) in the trial group ( P<0.05). Conclusion:All-suture anchors and single-row suture anchors are effective in rotator cuff repair, but the former results in better shoulder function and fewer periosteal reactions in the anchor insertion site in the early stage.

OBJECTIVETo fabricate organic-inorganic composite tissue engineering scaffolds for reconstructing calcified cartilage layer based on three-dimensional (3D) printing technique.

METHODSThe scaffolds were developed by 3D-printing technique with highly bioactive calcium-magnesium silicate ultrafine particles of 1%, 3% and 5% of mass fraction, in which the organic phases were composed of type I collagen and sodium hyaluronate. The 3D-printed scaffolds were then crosslinked and solidified by alginate and CaCl₂ aerosol. The pore size and distribution of inorganic phase were observed with scanning electron microscope (SEM); the mechanical properties were tested with universal material testing machine, and the porosity of scaffolds was also measured.

RESULTSPore size was approximately (212.3 ± 34.2) μm with a porosity of (48.3 ± 5.9)%, the compressive modulus of the scaffolds was (7.2 ± 1.2) MPa, which was irrelevant to the percentage changes of calcium-magnesium silicate, the compressive modulus was between that of cartilage and subchondral bone.

CONCLUSIONThe porous scaffolds for calcified cartilage layer have been successfully fabricated, which would be used for multi-layered composite scaffolds in osteochondral injury.

Bioprinting ; Cartilage ; growth & development ; Materials Testing ; Porosity ; Printing, Three-Dimensional ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

METTL3 and METTL14 are two components that form the core heterodimer of the main RNA m6A methyltransferase complex (MTC) that installs m6A. Surprisingly, depletion of METTL3 or METTL14 displayed distinct effects on stemness maintenance of mouse embryonic stem cell (mESC). While comparable global hypo-methylation in RNA m6A was observed in Mettl3 or Mettl14 knockout mESCs, respectively. Mettl14 knockout led to a globally decreased nascent RNA synthesis, whereas Mettl3 depletion resulted in transcription upregulation, suggesting that METTL14 might possess an m6A-independent role in gene regulation. We found that METTL14 colocalizes with the repressive H3K27me3 modification. Mechanistically, METTL14, but not METTL3, binds H3K27me3 and recruits KDM6B to induce H3K27me3 demethylation independent of METTL3. Depletion of METTL14 thus led to a global increase in H3K27me3 level along with a global gene suppression. The effects of METTL14 on regulation of H3K27me3 is essential for the transition from self-renewal to differentiation of mESCs. This work reveals a regulatory mechanism on heterochromatin by METTL14 in a manner distinct from METTL3 and independently of m6A, and critically impacts transcriptional regulation, stemness maintenance, and differentiation of mESCs.
Animals ; Mice ; Methylation ; Chromatin ; Histones/metabolism* ; RNA, Messenger/genetics* ; Methyltransferases/metabolism* ; RNA/metabolism*