This paper analyzed the moral construction in the prenatal diagnosis of surgical nursing and nursing features, including:strictness and complexity , professional and comprehensive , collaborative, and independence , carry out from the patients with preoperative evaluation , operation and postoperative effect evaluation every link and detail, with the theory of nursing ethics to guide and standardize nursing , dealing with the relation between various ethic, improve patient satisfaction , based on the premise of mutual modern relationship between nurses and pa-tients.

BACKGROUND:Cobalt chloride (CoCl2) may promote the proliferation of human umbilical cord-derived mesenchymal stem cels (hUC-MSCs) in a time- and concentration-dependent manner, and meanwhile, CoCl2 can regulate the expression of genes and proteins in hUC-MSCs. OBJECTIVE:To explore the effects of CoCl2 induced-hypoxia on the proliferation of hUC-MSCs and gene and protein expressions in hUC-MSCs, thereby establishing an effective method for MSCs culture and amplificationin vitro. METHODS: hUC-MSCs were extracted using tissue explant method. Under hypoxia conditions induced by CoCl2 (0, 100, 150, 200, 250 μmol/L) for different periods (0, 1, 2, 3, 4 days), flow cytometry was used to identify cel surface-associated antigens; cel counting kit-8 was used to detect cel proliferation; RT-PCR was used to determine levels of hypoxia inducible factor-1α, inducible nitric oxide synthase, stromal cel-derived factor-1, interleukin-6, transforming growth factor-β mRNA; western blot assay was used to detect protein expression of hypoxia inducible factor-1α. RESULTS AND CONCLUSION:The cels were positive for CD29, CD73, CD90, CD105, while negative for CD31, CD14, CD34, CD45, CD11b, HLA-DR. Moreover, the antigen expression was not affected by CoCl2 induced-hypoxia. CoCl2 induced-chemical hypoxia could promote the proliferation of hUC-MSCs in a time- and concentration-dependent manner. RT-PCR results showed thatunder hypoxia, hypoxia inducible factor 1α, inducible nitric oxide synthase and stromal cel-derived factor-1 mRNA expressions were significantly up-regulated, but interleukin-6 and transforming growth factor-β mRNA expressions were down-regulated significantly (P < 0.05). Additionaly, the protein expression of hypoxia inducible factor 1α was increased under hypoxia conditions. These findings indicate that CoCl2 induced-hypoxia environment may promote the proliferation of hUC-MSCs and the optimal concentration of CoCl2 is 200μmol/L. However, a higher concentration of CoCl2 (≥ 250μmol/L) inhibits the proliferation of hUC-MSCs, and the mechanism may be related to the increase of hypoxia inducible factor-1α at protein and mRNA levels.

Objective To discuss the efficiency of fibrin glue amikacin complex in controlling infection by observing the changes of leukocyte and neutrophilic granulocyte classifying counts after fibrin glue amikacin complex treated deep wound. Methods Clinical case-control study was used in the study. All patients were divided randomly into test group (100 patients) and control group (100 pa-tients), matched by wound location, wound size, time from injury to operation, combined injury and gen-eral antibiotics use to compare leukocyte and neutrophilic granulocyte classifying counts between both groups and observe possible toxic and side-effect in test group. Results Firstly, the test group and control group had the comparability in aspects of gender distribution, average age and injury mechanism (P >0.05). Secondly, there was statistical difference in classifying counts of leukocyte and neutrophilic granulocyte in the test group at different time points (P <0.05). The classifying counts of leukocyte and neutrophilic granalocyte peaked at 24 hours after operation, then decreased with treatment time and reached the lowest at 24 days after surgery or at day 1 before discharge. Thirdly, there existed statistical significance upon leukocyte counts in the test group and control group except for at day 1 after operation (P > 0.05), with lower counts in test group than control group. In aspect of neutrophil classifying counts, there was statistical significance (P < 0.05) at other time points in beth groups except for time points at days 1,2 and 12 (P >0.05). The test group had lower neutrophil classifying counts compared with con-trol group at different time points. Conclusion The fibrin glue amikacin complex has good clinical effort and high security, with no toxic or side effort in treatment of deep wound infection, and is worth clinical applicaiton.

BACKGROUND: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. METHODS: We screened adults over 20 years who were visited the health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. RESULTS: Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose. CONCLUSION: Associated factors of prevalence of asymptomatic gallstone were increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose, and were not different from those in West countries. further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to asymptomatic gallstone.
Adult ; Blood Glucose ; Cholesterol ; Eating ; Fasting ; Gallbladder ; Gallstones* ; Health Promotion ; Humans ; Korea ; Logistic Models ; Prevalence* ; Smoke ; Smoking ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

Objective To compare the effect of primary suture and T tube drainage of laparoscopic common bile duct exploration(LCBDE) in the treatment of patients with choledocholithiasis.Methods A total of 57 patients with calculus of extrahepatic bile duct were selected and they were randomly divided into observation group(n =25,treated by LCBDE) and control group(n =32,treated by T tube drainage).The operation time,postoperative recovery time of gastrointestinal tract,abdominal drainage time,postoperative hospital stay,hospitalization expenses and postoperative complications were recorded and compared between the two groups.Results All the patients were successfully completed surgery,and no patients had open surgery.The recovery time and postoperative hospital stay of the observation group were (1.7 ± 0.5) d,(5.3 ± 1.6) d,respectively,which were significantly shorter than (2.1 ± 0.3) d,(9.2 ± 1.9) d of the control group (t =11.73,6.27,all P ＜ 0.05),and the cost of hospitalization of the observation group was (6873 ± 2 541)RMB,which was significantly higher than (6 079 ± 2 492)RMB of the control group (t =5.93,P ＜ 0.05).The operation time and drainage time of the observation group were (86.3 ± 19.6) min,(89.7 ± 21.6) h,respectively,which were shorter than (97.1 ± 21.1) min,(98.2 ± 22.7) h of the control group,but the differences were not statistically significant(all P ＞ 0.05).There were 4 cases of postoperative bile leakage and 1 case of common bile duct residual stones in the observation group,and the incidence rate of complications was 20.00％.There were 2 cases of bile leakage,3 cases of common bile duct residual stones and 2 cases of biliary peritonitis in the control group,and the incidence rate of complications was 21.87％.There was no statistically significant difference in the incidence rate of complications between the two groups (x2 =0.15,P ＞0.05).All the patients were followed up for 1 to 2 years,the recurrence rate of stones in the observation group was 12.00％,which was similar to 15.60％ in the control group (x2 =0.36,P ＞ 0.05).Conclusion Primary suture of laparoscopic common bile duct exploration has the advantages such as less trauma,less pain,faster recovery and shorter hospital stay in the treatment of patients with choledocholithiasis,which is worthy of clinical application and popularization.

Objective To explore the diagnostic value of prenatal MRI in fetal Joubcrt syndrome and related disorders (JSRD).Methods Prenatal MRI data of 5 JSRD fetuses were analyzed retrospectively.The ratio of AP diameters of crown to root of molar tooth sign,the ratio of AP diameters of isthmus to interpeduncular fossa,and the ratio of the transverse to AP diameters of the roof of the fourth ventricle on the axial images of the midbrain were measured.Results Molar tooth signs were observed in 5 fetuses on the axial images of midbrain.The cerebellar vermis disappeared,and cleft sign was observed.Enlarged cisterna magna was observed in 3 fetuses.The ratios of AP diameters of crown to root were 0.58-0.90,of AP diameters of isthmus to interpeduncular fossa were 0.84-1.00,and of transverse to AP diameters of the fourth ventricle roof were 0.42-0.60.Conclusion Molar tooth sign and cleft sign were characteristic findings for JSRD on MRI,therefore being helpful to prenatal diagnosis of JSRD.

Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on activity in the intact motor cortex controlling the suprahyoid muscles and thus on dysphagia after an unilateral stroke.Methods Forty patients suffering dysphagia more than two weeks after a unilateral cerebral stroke were randomly divided into an experimental group and a control group,each of 20.Both groups were given traditional swallowing rehabilitation training,while the experimental group was additionally provided with 5 Hz rTMS for two weeks.Before and after the treatment,all of the patients were characterized using X-ray fluoroscopy,video fluoroscopic swallowing study (VFSS) and surface electromyography,and their swallowing was evaluated using a standardized swallowing assessment (SSA) and a penetration-aspiration scale (PAS).Results After the treatment,significant improvement was observed in both groups in the average swallowing time and in the maximum amplitude of sEMG,as well as the average SSA,PAS and VFSS scores (P＜0.05).The average values in the experimental group were in all cases significantly better than the control group's averages (P＜0.05).Conclusion Applying rTMS at 5 Hz to the motor cortex of the contralateral hemisphere controlling the suprahyoid muscles can effectively improve unilateral-hemisphere dysphagia after stroke.

ObjectiveTo investigate the expression and significance of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) in liver tissues after ischemia-reperfusion injury (IRI) in rats.MethodsSixteen Sprague-Dawley (SD) rats were randomized into the IRI group and the Sham group according to the random number table, 8 rats in each group. The portal vein and branches of hepatic artery of the rats in the IRI group were clamped with the atraumatic vascular clamp. After 45 min of ischemia, reperfusion was performed for 6 h. The porta hepatis of rats in the Sham group was exposed and the hepatic blood flow was not occluded. The morphological changes of the liver tissues in two groups were observed. The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were tested and the contents of HIF-1α and VEGF in liver tissues were determined. Data comparison between two groups was conducted usingt test.ResultsUnder light microscope, swelling, vacuolar degeneration of the liver cells, inflammatory cell infiltration, hepatic sinusoidal dilatation, disorganized hepatic cords and spotty necrosis were observed in the IRI group. The histomorphology of liver tissues in the Sham group was normal. The serum ALT and AST in the IRI group was respectively (1 007±130) and (1 307±72) U/L, which were significantly higher than (59±4) and (81±3) U/L in the Sham group (t=20.700, 48.448;P<0.05). The relative expression of HIF-1α and VEGF in liver tissues of IRI group was 1.77±0.10 and 1.86±0.05 respectively, which were significantly higher than 0.60±0.22 and 0.83±0.06 in the Sham group (t=13.623, 35.563;P<0.05).ConclusionThe expression of HIF-1αand VEGF in liver tissues increase significantly during early IRI, which may play a role in reducing the IRI of organism.

OBJECTIVETo explore the mechanisms of Chinese herbal medicine Sanqi Oral Liquid, composed of Astragalus membranaceus and Panpax notoginseng, in alleviating renal injury by observing its effect on the expressions of CD4(+), CD8(+) and CD68(+) cells in 5/6 nephrectomized rats with chronic renal failure.

METHODSA total of 102 SD rats were randomly divided into six groups: three treatment groups were administrated with high, medium and low dosage of Sanqi Oral Liquid respectively by gavage; a normal group, a 5/6 nephrectomized model group, and a group treated with coated aldehyde oxygenstarch were used as controls. Following oral administration of Sanqi Oral Liquid for 12 weeks, the general condition and renal pathological changes were observed, and the renal function, platelet count (PLT) and the expressions of CD4(+), CD8(+) and CD68(+) cells were determined for each group.

RESULTSThere were proliferation of mesangial matrix, renaltubularnecrosis and obvious tubulointerstitial fibrosis in the model group, and they were much milder in the treatment groups. Compared with the model group, the amounts of blood urea nitrogen (BUN), serum creatinine (Scr) and PLT in the treatment groups decreased (P<0.05 for all); and in the group administrated of medium dosage of Sanqi Oral Liquid, the expression of CD4(+) cells was up-regulated and those of CD8(+) and CD68(+) cells were down-regulated (P<0.05 for all), leading to an increased ratio of CD4(+)/CD8(+)(P<0.01).

CONCLUSIONSanqi Oral Liquid has a significant effect on regulating lymphocyte subsets, reducing the infiltration of macrophages in renal tissues and alleviating tubulointerstitial fibrosis, and this may be one of mechanisms of Sanqi Oral Liquid in delaying the progression of chronic kidney diseases.

Administration, Oral ; Animals ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Astragalus membranaceus ; chemistry ; CD4-Positive T-Lymphocytes ; drug effects ; pathology ; physiology ; CD8-Positive T-Lymphocytes ; drug effects ; pathology ; physiology ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Kidney Failure, Chronic ; drug therapy ; immunology ; pathology ; surgery ; Lymphocyte Count ; Male ; Nephrectomy ; Panax notoginseng ; chemistry ; Rats ; Rats, Sprague-Dawley ; Solutions

OBJECTIVETo investigate the effects of intrathecal ouabain and tizanidine injection for treatment of neuropathic pain in rats.

METHODSMale SD rats weighing 250-300 g were randomly divided into 5 groups (n = 6), namely the control group, ouabain group, tizanidine group, combined ouabain and tizanidine injection group, and the antagonist group. Intrathecal catheter was implanted 7 days before spinal nerve ligation to establish the neuropathic pain model. Mechanical withdrawal threshold (MWT) before and after intrathecal administration of the agents was recorded in the rats. Isobolographic analysis was performed to evaluate the interactions between the agents.

RESULTSIntrathecal injection of ouabain (0.25-5 microg) or tizanidine (0.5-5 microg) alone produced dose-dependent analgesic effect against the neuropathic pain (P < 0.05). Isobolographic analysis revealed a synergistic interaction between ouabain and tizanidine. Intrathecal pretreatment with atropine (5 microg) or yohimbine (20 microg) antagonized the effects of ouabain and tizanidine administered alone or in combination (P < 0.05).

CONCLUSIONIntathecal injection of ouabain or tizanidine produces dose-dependent analgesic effects against neuropathic pain, and their synergistic effect after combined injection probably involves the cholinergic transmission and alpha2 receptor.

Analgesics ; administration & dosage ; Animals ; Clonidine ; administration & dosage ; analogs & derivatives ; Injections, Spinal ; Ouabain ; administration & dosage ; Pain ; drug therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves ; injuries