Objective To explore the method of correctly placing and fixing mesh plug and patch in tension-free hernioplasty. Methods The data of 123 cases of plug-mesh tension-free hernioplasty with the method of placing and fixing mesh plug and patch were reviewed. Observed the incidence of postoperative effusion, infection, sinus formation, skin flap necrosis and hernia recurrence. Results All patients were restored after operation 8 days. Followed-up 1.5 -10.0 years,there was no incision effusion, infection,skin flap necrosis in all cases. No relapse happened on the operated side and 5 cases of inguinal hernia occurred on the non-operated side. Conclusions Mesh plug and patch must be placed to cover the whole abdominal wall defects,and contact closely with surrounding healthy tissue. They need to be placed neatly,fixed firmly and perpetually without any damage to the normal tissue structure.

Objective To establish the rat model for neurogenic bladder after complete suprasacral spinal cord injury, and analyze the urodynamics. Methods Forty adult Sprague-Dawley rats were randomly divided into control group (n=10) and experimental group (n=30). The spinal cord injury model on T10 was made with modified spinal cord transaction. The Crede's method was used to urinate assistantly af-ter modeling. The amounts of urine and successful rat model everyday were recorded. The urodynamics was measured in both groups, and the morphology was observed with HE staining. Results Four rats died in the experimental group. The amount of urine was the least and sta-ble on the 18th day, and 24 rats were successfully modeled on the 21st day. Compared with the control group, maximum bladder capacity de-creased (t=3.150, P=0.021), bladder base pressure, maximum bladder pressure and leak point pressure increased (t>3.125, P<0.01), and blad-der compliancy decreased (t=5.330, P=0.002) in the experimental group. Conclusion The complete suprasacral after spinal cord injury of neurogenic bladder in a rat model of manufacturing method is of high reliability, good repeatability, and low coefficient of variable character-istics for spastistic neurogenic bladder basic experimental studies.

Objective:To explore the effects of prenatal targeted psychological interventions combined with yoga on maternal anxiety, depression and maternal and infant outcomes.Methods:A total of 100 pregnant and puerperal women who were enrolled in Jining maternal and child health family planning service center from January 2021 to December 2022 and received regular prenatal care as required were selected as study subjects. According to the random number method, the subjects were divided into experimental and control groups, with 50 cases in each group. The experimental group was given targeted psychological interventions combined with yoga training, while the control group was given only traditional nursing. Then the differences of the self-rating anxiety scale (SAS) score, the self-rating depression scale (SDS) score, the general self-efficacy scale (GSES) score, the maternal and infant outcomes, body mass index (BMI) and the satisfaction of postpartum women were compared between the two groups. SPSS 26.0 software was used for analysis. The χ2 test, independent sample t-test, paired sample t-test were used for statistical analysis. Results:After the intervention, the scores of SAS and SDS of the experimental group were lower than those of the control group (SAS: (36.86±6.89), (44.12±11.04); SDS: (38.92±7.62), (48.20±10.44)), and the difference was statistically significant ( tSAS=-3.946, tSDS=-5.077, both P<0.05). Following the intervention, the GSES score of the experimental group was higher than that of the control group ((2.92±0.49), (2.57±0.58)), and the difference was statistically significant ( t=3.246, P<0.05). After the intervention, the cesarean section rate and the birth rate of macrosomia in the experimental group were lower than those in the control group(10.0%, 26.0%; 4.0%, 16.0%), and the rate of breastfeeding was higher than that of the control group(86.0%, 68.0%), and the differences were statistically significant ( χcesarean2=4.336, χmacrosomia2=4.000, χbreastfeeding2=4.574, all P<0.05). However, no significant difference was found in the postpartum hemorrhage rate between the experimental group and the control group ( P>0.05). Following the intervention, BMI of the experimental group was lower than that of the control group((26.11±2.18)kg/m 2, (28.02±1.97)kg/m 2, ( t=-4.609, P<0.05). In addition, postpartum women in the experimental group were significantly more satisfied than those in the control group (96.0%, 82.0%; χ2=5.005, P<0.05). Conclusion:The combination of prenatal targeted psychological interventions and yoga can reduce maternal anxiety and depression during pregnancy, get body back in shape after having a baby, and improve self-efficacy, satisfaction and the maternal and infant outcomes.

Objective To study the analysis of folic acid combined with vitamin for level two ischemic stroke prevention effect. Methods From April 2013 to January 2014 in our hospital , selected the patients with stroke in 100 cases as the research object. In digital method were randomly divided into observation group (50 cases) and control group (50 cases). The patients in the observation group was taken folic acid combined with vitamin , the control group only was given vitamins, in all patients on admission and at discharge on the plasma levels of Hcy, D-two dimer, fibrinogen, three glycerol, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol level, the effect of folic acid combined with the vitamin was observed. Results No significant differences between the two groups before treatment, plasma Hcy levels (P>0.05) in different ways, the observation group after treatment, the plasma Hcy levels were significantly lower than the control group , with significant difference ( P<0 . 05 ) . Two groups by different ways of treatment, the observation group was best accounted for 70% (35/50), the excellent and good rate was as high as 98% (49/50), significantly higher than the control group 44% (22/50) and 74% (37/50), with significant difference (P<0.05). On two groups of different ways of treatment of cerebral was stroke recurrence and score in patients with SIAS were compared, the recurrence rate of the observation group was lower than the control group, with significant difference (P<0.05), the SIAS score was significantly higher than that of the control group, with significant difference (P<0.05). Conclusion For the patients with stroke, should the use of folic acid combine with vitamin two level of prevention. The combine uses of folic acid and vitamin , can effectively reduce the incidence of stroke and recurrence rate.

Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

OBJECTIVETo investigate the expression and clinical significance of G protein-coupled receptor 31 (GPR31) in colorectal cancer tissue.

METHODSCancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated.

RESULTSGPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1% (15/124) vs. 4.1% (8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05).

CONCLUSIONSGPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.

Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Disease-Free Survival ; Humans ; Lymphatic Metastasis ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Risk Factors ; Survival Rate ; Up-Regulation

Objective:To explore the effects of strengthening night professional nursing of patients with open fractures of the lower extremities.Methods:From January 2019 to June 2020, convenience sampling was used to select 397 patients with open fractures of the lower extremities from the First Orthopedic Trauma, the Third Hospital of Hebei Medical University. Patients were randomly assigned to a control group and an observation group, respectively, to receive general nursing (control group) and strengthening night professional nursing (observation group). The control group was equipped with a regular number of nurses. In the observation group, an additional night nurse was assigned for patients undergoing surgery for open fractures of the lower extremities. The nighttime period was from 18∶00 to 8∶00 the next day. The night nurse arranged compensatory time off for the rest of the time or performance rewards. The hospital stay, hospitalization expenses, incidence of complications during hospitalization and half a year after surgery of the two groups were compared.Results:In the control group, there were 196 patients with open fractures of the lower extremities, and 46 patients underwent night surgery. In the observation group, there were 201 patients with open fractures of the lower extremities, and 40 patients underwent night surgery. There were no statistically significant differences between two groups in terms of surgical time, incidence of complications during hospitalization and half a year after surgery ( P>0.05). The hospital stay in the observation group was shorter than that in the control group, and the hospitalization expense was lower than that in the control group, with statistically significant differences ( P<0.05) . Conclusions:Strengthening night professional nursing can help shorten the hospital stay of patients undergoing surgery for open fractures of the lower extremities and reduce medical expenses.

Objective To observe the effect of electroacupuncture on Caspase-9, cytochrome C (Cyt-C) and apoptotic protease activating factor 1 (Apaf-1) protein in rats with neurogenic bladder after complete spinal cord injury. Methods A total of 60 female Sprague-Dawley rats were involved, in which 36 rats were randomly selected to establish the neurogenic bladder model with T10 spinal cord transected. 24 successful models selected were randomly divided into model group (n=12) and electroacupuncture group (n=12). The other 24 rats were also randomly divided into sham group (n=12) and blank group (n=12). The electroacupuncture group was electroacupunctured on Ciliao (BL32), Zhongji (RN3), Sanyinjiao (SP6) and Dazhui (GV14) for seven days. All of them were assessed with urodynamic test, TUNEL method was used to determine the apoptosis rate of the spinal cord, and Western blotting was used to detect the expression of Caspase-9, Cyt-C and Apaf-1 protein. Results Compared with the blank group and the sham group, the maximum bladder capacity and compliance decreased (P<0.01), the urinary bladder pressure and leakage point pressure increased (P<0.05); the apoptosis rate of the spinal cord increased (P<0.001); the expression of Caspase-9, Cyt-C and Apaf-1 protein increased (P<0.05) in the model group and the electroacupuncture group. Compared with the model group, the maximum bladder capacity and compliance increased (P<0.01), the urinary bladder pressure and leakage point pressure decreased (P<0.05); the apoptosis rate of the spinal cord decreased (P<0.05); the expression of Caspase-9, Cyt-C and Apaf-1 protein decreased (P<0.05) in the electroacupuncture group. Conclusion Electroacupuncture on Ciliao, Zhongji, Sanyinjiao and Dazhui could improve the bladder function after spinal cord injury in rats. The mechanisms may be related with the down-regulation of Caspase-9, Cyt-C and Apaf-1 protein to reduce apoptosis.

Objective:To investigate the associated factors of depressive symptoms among patients with neo-plasms.Methods:Nationwide(excluding Hong Kong,Macao,and Taiwan),30 505 residents were selected by a combination of stratified sampling and quota sampling according to the proportion of the seventh national population census.Patient Health Questionnaire-9(PHQ-9),General Anxiety Disorder-7(GAD-7),self-made questionnaire,and simplified perceived social support scale used to evaluate depressive symptoms,anxiety symptoms,behaviors,and perceived social support among patients with neoplasms.Results:Totally 359(1.2％)patients with self-repor-ted clinically diagnosed neoplasms were included,of which 151(42.1％)patients with malignant neoplasms and 208(57.9％)patients with benign neoplasms.The detection rate of depressive symptoms in patients with neo-plasms was 76.6％.Less than three days of walking for more than 10 minutes per day in the past week(OR=6.63),4-6 days of walking for more than 10 minutes per day in the past week(OR=5.00),the low(OR=4.80)or medium(OR=3.06)overall sleep quality,the lower perceived friend support(OR=4.66),and anxiety symp-toms(OR=1.74)among patients with neoplasms were risk factors for depressive symptoms.Conclusion:Patients with neoplasms generally might be at a high risk of depressive symptoms,especially for those patients with less ex-ercise,poor sleep quality,and low perceived social support.

Objective To investigate the expression and clinical significance of G protein-coupled receptor 31(GPR31) in colorectal cancer tissue. Methods Cancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated. Results GPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1%(15/124) vs. 4.1%(8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05). Conclusions GPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.