Objective To investigate the change of Na+ /dicarboxylate cotransporter (SDCT) 1 expression in renal tissues of rats with nephrolithiasis induced by ethylene glycol (EG) and the mechanism of potassium citrate prevention. Methods Male Wistar rats were divided into control, nephrolithiasis and potassium citrate treated groups. Calcium oxalate crystal deposition and histological changes in kidney were examined by anatomical and light microscope. The plasma and urinary biochemical parameters, such as citrate, oxalate etc., were analyzed by routine biochemical method. The expression of SDCT1 mRNA in kidneys was determined by Northern blot, and the change of SDCT1 protein abundance was detected by immunohistochemistry. Results On day 3, the animals in the nephrolithiasis group had a higher level of SDCT1 mRNA and protein abundance in kidneys, as well as a lower level of citrate in the urine when compared with the control group. However none of the rats in this group had obviously calcium oxalate crystal deposition in kidneys. On day 7 and 14, the expression of SDCT1 mRNA and protein abundance were shown further increase, when the urinary citrate concentration was decreased progressively, and 87. 5% to 100% of the rats in this group displayed a large quantity of calcium crystal deposition in the kidney. In the potassium citrate treated group, both the expression of SDCT1 mRNA and protein abundance were shown almost complete inhibited during the whole experiment time, meanwhile the urinary citrate level was significantly elevated with time; furthermore, the occurrence of the renal crystal deposition decreased to 37. 5% on day 14, and the pathologic changes such as tubular dilation and inflammatory cells infiltration were shown to be alleviated. Conclusions The upregulation of SDCT1 mRNA and protein abundance in kidney has a close relationship with hypocitraturia, which may play an important role in the development of nephroliathisis. The treatment with potassium citrate has a beneficial effect on the experimental nephrolithiasis rats through inhibiting the expression of SDCT1 in the renal tissue.

Objective To deeply know the psychological experience and coping style of patients with osteonecrosis of the femeral head (ONFH) in the process of free vascularized fibular graft transplantation, and provide basis for the development of targeted interventions.Methods Semi-structured in-depth interviews were used to investigate 10 cases of patients undergoing free vascularized fibular graft transplantation for femoral head necrosis by phenomenology method. Colaizzi data analysis principles were used to analyze and refine topic. Results Three themes were extracted: patients with insufficient understanding of disease and treatment; patients under high pressure; change of self-consciousness.Conclusions In the process of free vascularized fibular graft transplannation for ONFH, medical staff should have much more communication with patients, and provide more support and help for patients and their families. Through the psychological support, effective rehabilitation guidance and correction of bad habits the treatment effect and patients' coping capabilities would be improved.

Objective To explore the clinical effects of traumatic orthopedics nursing skills homogenization training in our partner hospitals. Methods Totally 97 orthopedics nurses from 8 partner hospitals of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were selected to attend the traumatic orthopedics skills homogenization training in four batches between March and June 2018. Training contents included theories and performance standards, clinical practice and examination of nursing skills. Training methods included intensive classroom teaching, group discussion and operation practice. The managers and trainees were investigated with the self-designed questionnaire after the training, which concerned training models, training contents, curriculum, teaching quality and teaching ability of the trainers. Results The satisfaction with the nursing skills homogenization training in the nursing mangers and 97 trainees from the 8 hospitals was 100%;and the 97 trainees' satisfaction with curriculum, training contents and the trainers' teaching ability was (4.88±0.361), (4.93±0.260) and (4.94±0.282), respectively. The nurses' satisfaction with the training scored higher than 4.70 in all dimensions;and the total score of training management was (4.88±0.331). Conclusions The intensive training of traumatic orthopedics nursing skills improves the specialized skills and service abilities of the orthopedics nurses in the hospitals, enable patients to receive homogeneous nursing, and accelerate patients' healing, which is worth promoting in clinical practice.

Objective To investigate the anxiety level, caregivers' burden level and its influence factors of patients undergoing conservative treatment with osteonecrosis of the femoral head(ONFH). Methods A total of 90 hospitalized patients undergoing ONFH in orthopedics in Shanghai Sixth People's Hospital were included using convenient sampling from January 2016 to July 2016. Zung self-rating anxiety scale (SAS), visual analogue scale (VAS), Chinese version of Zarit Burden Interview(ZBI) and Simplified Coping Style Questionnaire were used for the questionnaire.Results The incidence rate of anxiety was 32.2%, whereas statistically significant differences were observed between male and female patients(P<0.05). The score of ZBl was (48.88±11.59) and 75.6% of caregivers showed moderate to high level of burden. There were statistically significant differences in the levels of caregiver burden among patients with different genders, educational levels and family caregivers (P<0.05). Caregivers with different characters had different coping styles. The coping style scores of caregivers with different genders, educational levels and family roles caregivers were statistically significant different (P<0.05).Conclusions Patients undergoing ONFH have anxiety. The caregivers also suffer from different levels of burden. Nurses should provide services for patients, pay attention to the physical and mental health of patients and caregivers and reduce their care burden so as to improve their quality of life.