Objective This study aimed at observing expression and clinical significance of metadherin in gastric adenocarcinoma and exploring the potentially regulating mechanism of metadherin in invation and migration of gastric cancer.Methods Expressions of metadherin and E-cadherin in primay lesion of gastric cancer were detected by immunohistochemistry and their correlation to clinicopathologic characteristics and prognosis were analyzed by Chi-square tests.Transwell assay and wound healing assay were applied for the ability of invasion and metastasis in gastric cancer cells.Then,the down-regulatied metadherin expression in MKN45 cells by RNA interference (siRNA) was carried out and furthermore,the regulation role of metadherin in epithelial-mesenchymal transition was analyzed also in invasion and migration of gastric cancer cells.Results The positive expression of metadherin was correlated to invading depth (P =0.029),lymph node metastasis (P =0.001),TNM stage (P =0.014) and inhibiting E-cadherin expression (P =0.001).The patients with positive metabherin shared poorer prognosis.Furthermore,the down-regulated metabherin in MKN45 cells would result in the increasing expression of E-cadherin,as well as decreasing expression of N-eadherin,Slug and Snail.At the same time,the abilities of invasion (P =0.027) and migration (P =0.008) of MKN45 cells was decreased.Conclusion metabherin induces EMT in metastasis of gastric adenocarcinoma via activating either Slug or Snail but not twist,which would result in the poorer prognosis.

Objective Using MRI compatible OxyLiteTM fiber-optic microprobes to verify the reliability of detecting the oxygenation changes in rats C6 glioma by BOLD fMRI with non- hemodynamic response function (non-HRF) post-processing algorithm. Methods A total of 20 male SD rats were used to establish the subcutaneous C6 glioma model. GRE-EPI BOLD fMRI scans were performed in the tumor-bearing rats with Carbogen inhalation after anatomic scans using 1.5 T MR imaging system with
Micro-47 microscopic coil. Fiber-optic microprobes were implanted in tumor to acquire the dynamic pO2 indications during BOLD fMRI scan.“Oxy-localization map”and“oxy-amplitude map”were generated from BOLD functional image data by non-HRF post-processing algorithm analysis. A ROI about 1.5 mm on a side centered to the tip of microprobe was defined on the MRI morphological image, and then was copied onto the“oxy-localization map”and“oxy-amplitude map”to extract the values of significant re-oxygenation (T), percent BOLD signal change (ΔPSC). The mean difference of pO2(ΔpO2) measured by fiber-optic microprobes before(pO2-Air)and after (pO2-Car)Carbogen inhalation in the ROI areas was calculated. Correlation analysis was madebetween cov (T value, Δ pO2) and cov (ΔPSC value, Δ pO2). The difference between pO2-Air and pO2-Car were tested by Mann Whitney U test. Results pO2 was successfully measured and recorded from 23 points in tumor using fiber-optic microprobe during the BOLD fMRI scan. The analysis results both of physiological and functional imaging parameters were as follows: pO2-Air=2.285(19.056) mmHg,pO2-Car=14.701(48.390)mmHg,ΔpO2=8.107(33.557)mmHg,ΔPSC=0.402(2.192)%,T=2.025 (8.293). (1) 10 points were identified clearly in parenchyma area of tumor. The mean value of pO2 during air inhalation [19.462(21.511)mmHg] significantly increased after Carbogen inhalation [59.904(56.710)mmHg] (U=14.000,P=0.007). (2) 5 points were identified in tumor necrosis area. The mean value of pO2 during air inhalation [0.149(0.479)mmHg] showed no significant change comparing with Carbogen inhalation[0.273 (8.050)mmHg](U=9.000,P=0.465). (3) 8 points were identified in the boundary of tumor parenchyma and necrosis areas. Among which, 5 showed the similar pO2 change to that located in tumor necrosis area, 2 showed the similar to the tumor parenchyma. However, the pO2 showed continuously decrease after Carbogen inhalation in the last 1 point. TheΔpO2 measured from the total of 23 points correlated positively toΔPSC and T value extracted from the corresponding ROI (r=0.660,0.576,P<0.01). TheΔpO2 measured from 10 points in tumor parenchyma correlated positively to ΔPSC(r=0.717,P=0.020). Conclusion“Oxy-localization map”and“oxy-amplitude map”generated from BOLD fMRI combined with non-HRF post-processing algorithm could show reliably not only the location but also the extent where the re-oxygenation occurred within tumor.

With rapid development of our country's intensive medical, intensive medical doctors and nurses pay more and more attention to analgesic and sedation strategy. How to implement the analgesic and sedation strategy, the most important thing is how to eliminate the patients with severe pain, restlessness, anxiety, delirium, the purpose of inducing anterograde amnesia. This article expound the four aspects of content: the depth of sedation, the drug of analgesic and sedation, the analgesic and sedation strategy, nursing intervention. We provide some references for analgesic and sedation strategy in the future.

The co-culture system of early embryos and cancer cells is an important means to observe the biological behavior changes of embryos and cancer cells in vitro. In this study, we co-cultured the 3.5 dpc mouse embryo with malignant tumor cells, investigated the development of blastocyst by observing the hatchment, attachment and outgrowth, observed the biological behavior changes of cancer cells in the embryonic circumstances, and detected the proliferation and apoptosis of cancer cells. Compared with the control, the embryos developed normally in the tumor environments, and the rate of hatchment, attachment and outgrowth increased significantly (P<0.05). However, there was no significant change of cancer cells in morphology, proliferation and apoptosis in the co-culture system (P>0.05). Under the co-culture system, the early embryo developed normally, and the cancer cells also grew well. There may be similarities between the embryos and cancer cell's choice for living. Moreover, the growth of embryos could be promoted by cancer cells in the co-culture system. This might be related to the similarities of gene expression, growth factors and signal transduction mechanisms between embryos and cancer cells.
Animals ; Blastocyst ; cytology ; physiology ; Cell Line, Tumor ; Coculture Techniques ; Embryo Culture Techniques ; methods ; Embryo, Mammalian ; cytology ; Humans ; Liver Neoplasms ; pathology ; Male ; Melanoma ; pathology ; Mice

Objective: To verify the application effect of self-developed strait jackets to patients with restlessness in intensive care unit. Methods: Broke through the traditional constraint method of restraint tool and design a kind of full-body strait jacket for the purpose of protection, restraint and convenience. The patients in the intensive care unit of our hospital were randomly selected from June 2017 to May 2018 by convenient sampling method. There are 48 cases in the experimental group and 48 cases in the control group. The patients in the experimental group were restrained by full-body strait jackets and the patients in the control group were restrained by wrist restraint strap. The rate of release of restraint tools, the incidence of skin pressure injury and the incidence of limb skin edema, comfort level were observed. Results: The incidence of stress injury, unplanned extubation rate, hydroderma rate at the limb end and release rate of restraint band in the experimental group were 2.08% (1/48), 2.08% (1/48), 4.16% (2/48), 6.25% (3/48) respectively, while the rates in the control group were 14.58% (7/48), 16.66% (8/48),22.91% (11/48), 22.91% (11/48) respectively. The difference between the two groups was statistically significant (χ²=4.909, 6.007-7.207, P<0.05). Conclusion The full-body strait jacket can protect the patients better, effectively reduce the incidence of stress injury, prevent patients from releasing, reduce unplanned extubation, reduce skin edema at the extremities, improve the comfort level of patients, and facilitate nurses to check patients.

BACKGROUND:Anterior cruciate ligament injury tends to lead to secondary meniscus injury and osteoarthritis.At present,there are few studies on the mechanics of meniscus and articular cartilage injury caused by anterior cruciate ligament injury. OBJECTIVE:To study the effect of partial rupture of the anterior cruciate ligament on the stress of medial and lateral meniscus and articular cartilage of knee joint by finite element analysis. METHODS:The CT and MRI images of the knee joint of a healthy volunteer were selected,and the scan data were imported into Mimics,Geomagic and SolidWorks software.After registration and fusion,four kinds of three-dimensional knee joint models were established:models of intact anterior cruciate ligament,rupture of the posterior external tract of anterior cruciate ligament,rupture of the anterior internal tract of anterior cruciate ligament,and absence of anterior cruciate ligament.Finally,data were imported into Ansys software to apply four different modes of loads to the knee joint:Longitudinal loads of 750 N were applied to the top of the femur;longitudinal load of 750 N to the top of the femur and forward thrust of 134 N behind tibia;a longitudinal load of 750 N and a varus moment of 10 Nm were applied to the top of the femur to simulate genu varus;750 N longitudinal load and 4 Nm internal rotation moment were applied to the proximal end of the femur to simulate knee internal rotation.The finite element analysis of biomechanical stress changes of the meniscus and articular cartilage of the knee joint was carried out. RESULTS AND CONCLUSION:(1)In the straight position of the knee joint,when the anterior medial tract of the anterior cruciate ligament was broken and the anterior cruciate ligament was missing under longitudinal loads of 750 N at the top of the femur,the total stress and peak value of meniscus increased significantly,but the stress distribution of the meniscus and the stress of articular cartilage did not change significantly.In longitudinal load of 750 N to the top of the femur and forward thrust of 134 N behind tibia,the fracture of the anterior internal tract of the anterior cruciate ligament increased the tibia forward,the compressive stress of posterior angle of the meniscus increased,and the stress of the articular cartilage did not change significantly.During simulating genu varus,the posterior angular stress of the lateral meniscus decreased,the stress of the medial meniscus increased,and the stress of articular cartilage slightly decreased when anterior cruciate ligament injuries were complete.When the anterior internal tract of the anterior cruciate ligament was broken or absent under knee internal rotation,the equivalent stress peak value of femoral cartilage and tibia cartilage shifted from medial cartilage to lateral cartilage,and the stress peak value of meniscus increased significantly.At this time,the anterior internal tract of the anterior cruciate ligament played a leading role in the rotational stability of the knee joint.(2)These results indicate that the risk of secondary meniscus injury in patients with anterior and medial anterior cruciate ligament band rupture was much higher than that in patients with posterior and external anterior cruciate ligament band rupture when the knee was in the upright standing position,varus and pronation,and there was no significant difference in the impact on articular cartilage.

BACKGROUND:The incidence of medial collateral ligament injuries in the knee joint is easy to lead to secondary meniscus and cartilage damage,and long-term chronic damage can lead to the occurrence of osteoarthritis.At present,there are few studies on the mechanics of meniscus and articular cartilage injury caused by medial collateral ligament rupture. OBJECTIVE:To investigate the effect of different degrees of medial collateral ligament injury on the biomechanics of meniscus and cartilage of knee joint. METHODS:The CT and MRI examinations of the knee joint of a healthy volunteer were performed to obtain the image data.The scanning data were imported into Mimics,Geomagic,and Solidworks software in turn.After registration and fusion,a 3D model of normal knee joint was established.On this basis,models of medial collateral ligament injury in different degrees of knee joint were simulated,which were divided into four groups,including:(1)medial collateral ligament was intact;(2)deep medial collateral ligament fracture;(3)superficial medial collateral ligament fracture;(4)complete rupture of medial collateral ligament.Finally,Ansys software was introduced to apply three modes of loads to the knee joint:(1)10 N·m valvaration torque was applied to the top of the femur.(2)A 4 N·m internal torque was applied to the top of the femur.(3)A 4 N·m external torque was applied to the top of the femur.The effects of four groups of models on knee biomechanics under different loads were analyzed. RESULTS AND CONCLUSION:(1)In the extension position of the knee joint,when a 10 N·m valgus torque was applied to the knee joint,the overall stress of the posterolateral meniscus increased with different degrees of medial collateral ligament injuries,while the stress of the articular cartilage did not change significantly.The peak stress of the posterolateral meniscus increased significantly with superficial medial collateral ligament rupture.(2)In the knee extension position,when a 4 N·m internal rotation torque was applied to the knee joint,the overall stress of the medial and lateral meniscus increased after different degrees of medial collateral ligament injury.When superficial medial collateral ligament rupture occurred,the peak stress of the meniscus shifted from the anterior horn of the medial meniscus to the anterior horn of the lateral meniscus.(3)In the knee extension position,applying a 4 N·m external rotation torque to the knee joint,the peak stress of the posterolateral meniscus increased more significantly than that of the medial meniscus,and the stress of the articular cartilage changed less.(4)These results show that the risk of meniscus injury secondary to superficial medial collateral ligament rupture is much higher than that of deep medial collateral ligament rupture when the knee is in extension,and the lateral meniscus is more vulnerable to injury than the medial meniscus.Both superficial medial collateral ligament and deep medial collateral ligament play an important role in the rotational stability of the knee joint.

To explore the relationship between cancer awareness and the survival of the patients with non-small cell lung carcinoma (NSCLC).
 Methods: A total of 865 NSCLC patients were screened for the risk factors, including age, gender, address, tumor/lymph nodes/metastasis (TNM) stage, and cancer awareness. Survival of the patients was calculated by Kaplan-Meier method and Cox regression analysis.
 Results: After an average observation time of 304 d (ranging from 0 to 4 718 d), 62 of the 394 patients in the cancer awareness group survived, whereas 26 of the 471 patients in the cancer concealment group survived. Cancer-specific and all-cause survival was poorer in the cancer concealment group (P<0.001 for each, log-rank test). Cox multivariate regression analysis showed that cancer concealment displayed significantly lower cancer-specific survival [hazard ratio (HR)=1.534, 95% confidence interval (CI) 1.320 to 1.784, P<0.001] and all-cause survival (HR=1.558, 95% CI 1.346 to 1.803, P<0.001).
 Conclusion: Cancer concealment is associated with a poor survival of NSCLC patients, which may prohibit the patients from obtaining the real "right to survival".
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms ; Lymphatic Metastasis ; Prognosis ; Proportional Hazards Models

To investigate the value of injecting a small amount of absolute ethanol into the benign solid nodules of the thyroid before radiofrequency ablation(RFA)to improve the efficiency of radiofrequency ablation. A total of 98 eligible patients(98 nodules)with pathologically confirmed benign solid nodules who were treated in our center from December 2016 to February 2018 were included and randomized into ethanol ablation(EA)combined with radiofrequency ablation(RFA)group(EA+RFA group)and RFA group,with 49 patients in each group.Routine ultrasound,contrast-enhanced ultrasound(CEUS),and thyroid function test were performed before treatment and 1,3,6,and 12 months after treatment.The general information,treatment time,ablation energy,ablation power,postoperative nodule volume reduction ratio(VRR),symptom score(SS)and cosmetic score(CS),thyroid function level,and incidence of complications were compared between these two groups. The mean treatment time [(441.30±243.31)s (790.70±349.82)s;= 4.403, =0.000],mean ablation energy [(3.92±2.01)kJ (5.15±2.12)kJ;=2.709, =0.009],and mean ablation power [(6.07±1.44)W (7.30±1.29)W;=3.612, =0.006] were significantly lower in the EA+RFA group than in the RFA group.At 3,6 and 12 months after surgery,the VRR in the EA+RFA group was(57.73±11.07)%(=-3.16, <0.001),(64.40±10.56)%(=-5.45, <0.001),and(77.29±8.48)%(=-10.46, <0.001),respectively;the VRR in the RFA group was(55.44±13.01)%(=-1.76, <0.001),(65.28±11.33)%(=-5.09, <0.001),and(75.17±9.84)%(=-8.93, <0.001),which were significantly smaller than those before surgery.There was no significant difference in VRR between the EA+RFA group and the RFA group at 1(=3.41, =0.33),3(=2.05, =0.21),6(=2.77, =0.49),and 12 months(=5.05, =0.10)after treatment.During the follow-up,no recurrence of nodules was observed on CEUS.In the EA+RFA group,the SS [(1.77±0.86).(5.54±2.15);=9.63, <0.001] and the CS[(1.39±0.77).(3.32±0.61);=10.09, =0.004]at 12 months after surgery were significantly lower than those before surgery.In the RFA group,SS [(1.63±1.04).(5.90±1.79);=12.72, <0.001] and CS [(1.64±0.83).(3.15±0.72);=8.13, =0.012] at 12 months after surgery were also significantly lower than those before surgery.The CSS in the EA+RFA group was significantly lower than that in the RFA group [(0.93±0.55).(2.44±0.53);=-11.70, =0.007].Both groups had no significant change in thyroid function during the follow-up period,and no serious complications were observed. Anhydrous alcohol injection can effectively improve the efficiency of radiofrequency ablation in treating benign solid thyroid nodules and is effective in reducing nodule volume,alleviating compressive symptoms,and decreasing cosmetic discomfort.
Catheter Ablation ; Ethanol ; Humans ; Neoplasm Recurrence, Local ; Prospective Studies ; Thyroid Nodule ; Treatment Outcome