Objective To study patients experience in and needs for vaginal douching in the department of gynecology.Method Using semi-structured interviews,10 patients undergoing vaginal douching in the hospital were selected,and then the interviews were analyzed and described with the content analysis method.Results Before vaginal douching,the patients had some psychological states of tension,fear,shyness,fear and calmness.In the process of vaginal douching,the patients experienced comforts,pain,fear,shyness and dissatisfaction with water temperature and skin preparation.After vaginal douching,the patients experienced worries of different sorts like vaginal infections,sexual life and pregnancy.The patients needed for the douching-related knowledge and the improvement in hygienic situations and they had some questions about urination and defection,operative effect and bathing and infection.Conclusion Medical staff should provide the corresponding services for patients during vaginal douching according to their needs and individual situations so as to enhance the nursing service quality.

Cisplatin, an efficient anticancer agent, can trigger multiple apoptotic pathways in cancer cell. However, the signal transduction pathways in response to cisplatin-based chemotherapy are complicated, and the mechanism is not fully understood. Using fluorescence resonance energy transfer (FRET) technique, the molecular mechanism of cisplatin-induced apoptosis in living human lung adenocarcinoma cells (ASTC-a-1) were investigated. After cisplatin treatment, the recombinant pFRET-Bid and pSCAT-3 probes were used to determine the kinetics of Bid cleavage and Caspase-3 activation, respectively. The fluorescence probes Bid-CFP and DsRed-Mit were also used to detect the spatial and temporal changes of Bid in real-time in sub-cell level. The results showed that a cleavage of the Bid-FRET probe occurring at about 4～5 h after treated with 20 ?mol/L cisplatin. Cleavage of the Bid-FRET probe coincided with a translocation of tBid from the cytosolic to the mitochondria, and the translocation lasted about 1.5 h. At the anaphase of cell apoptosis, Caspase-3 was activated obviously as detected by FRET and Western blotting techniques. Using real-time single-cell analysis, it was observed the kinetics of Bid and Caspase-3 activation for the first time in living cells during cisplatin-induced apoptosis.

Obstructive sleep apnea syndrome (OSAS) is endangering human health seriously now. We had reviewed some typical animal model which had at least one OSAS character of intermittent hypoxia and/or hypercapnia, upper airway obstruction and sleep structure disorder. However, all of these models could not simulate clinical and pathological features of OSAS completely. Establishing a suitable animal model to study OSAS and related diseases is very important.
Airway Obstruction ; etiology ; Animals ; Disease Models, Animal ; Humans ; Hypercapnia ; etiology ; Hypoxia ; etiology ; Sleep Apnea, Obstructive ; complications

BACKGROUND:Conventional therapies for lumbar spondylolisthesis can result in trauma,bleeding and low back pain.With the vigorous development of spinal biomechanics and novel spinal fixation systems,we have more understanding on the reduction and fusion after spondylolisthesis.OBJECTIVE:To observe the clinical effects of transforaminal lumbar interbody fusionvia the quadrant system on lumbar spondylolisthesis and related biomechanical changes.METHODS:A retrospective analysis was done in 23 patients with lumbar spondylolisthesis undergoing transforaminal lumbar interbody fusionviathe quadrant system admitted from June 2012 to September 2013.Oswestry disability index and visual analog scale score were detected at 3 months and 1 year after treatment,as wel as fusion conditions and internal fixation with or without loosening or breakage.RESULTS AND CONCLUSION:Al patients were successfuly treated,with no cerebrospinal fluid leakage and nerve injury.Incisions were healed wel in al cases except one case suffered from incision infection that wascontroled after 10 days of antibiotic treatment.Al the patients were folowed up.The Oswestry disability indexes and visual analog scale scores were significantly improved at 3 months and 1 year after treatment (P ＜0.05),but there was no difference in these two scores at 3 months and 1 year after treatment (P＞0.05).The improvement rates of Oswestry disability index and visual analog scale score were (65.3±14.8)％and (58.2±12.0)％,respectively.These findings indicate that the transforaminal lumbar interbody fusionvia the quadrant system is safe and effective to correct lumbar spondylolisthesis,maintains the biomechanical stability,improves patient's symptoms,reduces the incidence of low back pain and improves the quality of life.

Objective To investigate the effectiveness of glucocorticoids in the treatment of granulomatous lobular mastitis (GLM), and to discuss the optimal stage to add glucocorticoids during the treatment. Methods Twenty-four patients having received the core needle biopsy were involved. Ten cases with the explicit pathological diagnosis received the glucocorticoids therapy following the subtotal excision after remission. Pathological diagnoses of the rest 14 patients were undefined. For these 14 patients, simple partial excisions were given and the postoperative pathological diagnoses were presented as the GLM. Of all the 14 patients who accepted the surgical treatment firstly, 8 patients received the postoperative glucocorticoids adjuvant therapy. For the rest 6 patients, steroid hormone therapy was not used after surgery, and they were followed up postoperatively. All patients' clinical and pathological information were collected and analyzed. Results All patients were followed up for 6-36 months (average 18) by the outpatient service. Of all the 10 patients who received the glucocorticoids therapy before surgery, only 1 patient of them got the GLM recurrence. For the 8 patients who received the postoperative glucocorticoids treatment, only 1 patient got the recurrence. For the 6 patients who received simple partial excision, the recurrence of the GLM may be up to 3. There was no statistical difference between the two groups who both received the 05). But compared with the pure surgery treatment, the difference was obviously (P<0.05). Conclusions The clinical presentation and imaging performance of GLM are unspecific, so the diagnosis of the GLM is difficult. There is no consensus regarding the optimal treatment for GLM. The glucocorticoids therapy may be necessary preoperatively or postoperatively. For the patient with clear preoperative biopsy diagnosis, preoperative glucocorticoids adjuvant chemotherapy followed by the wide excision may be an effective method.

AIM:To establish a liquid chromatography method for determining the monosaccharide composition of human lipoproteins, and to investigate the differences between diabetic patients and healthy participants.METHODS:Liquid chromatography with pre-column derivatization was used to determine the neutral and basic monosaccharides, and liquid chromatography tandem mass spectrometry was applied to quantify N-acetylneuraminic acid content.RESULTS:The contents of mannose, glucosamine, N-acetylglucosamine, glucose, galactose and N-acetylneuraminic acid in high-density lipoprotein from healthy participants and diabetic patients were (5.88 ±0.94),(16.49 ±4.11),(1.31 ±0.33), (0.87 ±0.16), (7.18 ±1.64), (2.14 ±0.12) mmol/(g protein) and (8.68 ±0.39), (24.73 ±5.50), (1.91 ±0.54), (1.23 ±0.35), (9.73 ±2.85), (3.53 ±0.27) mmol/(g protein), respectively.The contents of mannose, glu-cosamine,N-acetylglucosamine, glucose, galactose and N-acetylneuraminic acid in low-density lipoprotein from healthy par-ticipants and diabetic patients were ( 29.20 ±3.57 ) , ( 50.77 ±4.72 ) , ( 5.28 ±0.64 ) , ( 10.06 ±1.37 ) , ( 28.44 ± 3.96),(6.86 ±0.11) mmol/(g protein) and (30.08 ±3.78), (38.52 ±6.38), (3.79 ±0.78), (7.63 ±1.50), (20.05 ±2.63), (6.45 ±0.18) mmol/(g protein), respectively.The contents of mannose, glucosamine, glucose, ga-lactose and N-acetylneuraminic acid in very-low-density lipoprotein from healthy participants and diabetic patients were (91.21 ±4.12), (27.05 ±2.34), (4 230.95 ±15.83), (43.40 ±3.75), (2.95 ±0.24) mmol/(g protein) and (82.40 ±0.51), (30.16 ±0.32), (4 722.73 ±93.27), (34.05 ±2.81), (4.42 ±0.15) mmol/(g protein), respec-tively.CONCLUSION:Liquid chromatography with pre-column derivatization is suitable for the neutral and basic mono-saccharide analysis in human lipoproteins, and the glycosylation of lipoproteins in diabetic patients are significantly changed compared with the healthy controls.

Objective To investigate the effects of lentiviral-mediated RNA interference (RNAi) targeting tumor necrosis factor-α(TNF)-αgene on the expression of TNF-α, interleukin (IL)-1β, IL-6 of murine macrophages RAW264.7, and the efficiency of RNAi experimental gene therapy for the murine collagen-induced arthritis (CIA). Methods The RAW264.7 macrophages were infected by lentivirus-RNAi particles, then stimulated by Lipopolysaccharides (LPS). The TNF-α, IL-1β, IL-6 expression of RAW264.7 macrophages were measured with real-time polymerase chain reaction (PCR) and enzyme linked immunosorbent assay (ELISA). CIA models were esta-blished in DBA/1 mice using bovine type Ⅱ collagen. The treatment effect of lentivirus-RNAi on CIA were observed through arthritis scores, serum TNF-α measurement and hind paw paraffin section hematoxylin/eosin staining after lentivirus-RNAi particles tail vein injection. Results The TNF-αmRNA relative expression level of lentiviral RNAi group was 0.291 ±0.021, significantly lower than that of negative control group 0.925±0.013 (t=25.4, P<0.01). The inhibition rate in mRNA levels was 68.5%. The serum TNF-α level of lentiviral RNAi group was [(249 ±11) ng/ml], significantly lower than that of negative control [(382±6) ng/ml] (t=10.31, P<0.05). The inhibition rate of protein levels was 34.7%. It had no effect on the IL-1β and IL-6 mRNA expression. On the 8th day after systemic administration, the arthritis score of lentivirus-RNAi group was 2.50±0.19, which was significantly lower than that of blank controls (3.63 ±0.18) and negative controls (3.75 ±0.16) (F=42.8, P<0.01). From now on, arthritis score of lentivirus-RNAi group and positive control decreased slowly to at least 2 weeks after treatment induction. The serum TNF-α levels of lentivirus-RNAi group and positive controls were [(35±6) pg/ml] and [(32±7) pg/ml] significantly lower than that of negative controls [(47±3) pg/ml] (t=3.03, 4.11, P<0.01) respectively. Morphological examination showed that the lentivirus-RNAi decreased CIA pathological manifestations. Conclusion Lentiviral-mediated RNAi targeting murine TNF-α gene can effectively inhibit TNF-α expression both in vitro and in vivo, which also effectively improve the CIA arthritis score. Lentiviral-mediated RNAi targeting TNF-αgene provides a potential strategy for rheumatoid arthritis (RA) treatment.

Objective To compare the displacements of the clips in the cavity measured with orthagonal kilovoltage (KV) X-my plain film in conditions of moderate deep inspiration breathing hold(mDIBH) and free breath (FB), and compare the margins from clinical target volume (CTV) to planning target volume (PTV) based on the displacements. Methods Before radiotherapy, 2 and 5 sets of orthogonal KV plain film were respectively collected in mDIBH and FB group, then the automatic registration of the reconstructed KV plain film and DRR derived from the planning OF images was finished. In conditions of mDIBH and FB, the displacements of the selected clip at the same location in the different directions and of the different selected clips in the same direction were compared. The margins in three dimensional directions were calculated and compared in conditions of mDIBH and FB . Results In FB hold group, the difference of displacement in left-right (LR), cranial-caudal (CC) and anterior-posterior (AP) directions were statistically significant between the clips at the cranial and caudal border of the cavity (9. 7 mm and 10. 6 nun (Z = -2. 12,P =0. 037) ,7. 3 mm and 8. 3 mm (Z = -2. 31 ,P=0. 041) ,15.5 mm and 16. 1 nun (Z = -2. 32,P = 0. 041)), but not statistically significant for the clips at the bottom and lateral P=0.814),15.7 mm and 16.5 mm (Z=-0.26,P=0.856)). The corresponding differences in the different directions were statistically significant (5.0 mm and 7. 8 mm(Z = -2. 31, P =0. 036), 5.0 mm and 9. 3 nun (Z= -2. 21,P=0. 021),7. 8 mm and9.3 mm (Z= -2. 11,P=0.041)). In FB group, the differences of the displacements of the four selected clips were statistically significant in CC and AP directions (7.3 mm and 8.4 mm (Z= -2.45,P=0.021), 15.5 mm and 16.5 mm (Z= -2.41,P= 0.043)), but not in LF direction (10.6 nun and 10.6 mm (Z= -0.24,P=0. 815)). In mDIBH group, the displacements in LF direction were statistically significant (4. 4 mm and 5.4 mm (Z = -2. 31, P = O. 031)), but not in CC and AP directions (8. 6 mm and 8.6 mm (Z =-0. 21, P = 0. 815), 10. 5 mm and 10. 8 mm (Z = -0. 27 ,P =0. 754)). There were statistically significant difference of the margins in LF and AP directions (9.7 mm and 5.0 mm (Z= -2.34,P=0.029),15.5 mm and 9.3 mm (Z= -2. 31,P= 0.021)), but not in CC direction (7.3 mm and 7. 8 mm (Z= -0.29,P =0.770)) between mDIBH and FB conditions. Conclusions The margins extended from CTV to PTV for EBPBI should be determined based on the respiratory status, border location and border direction.

Objective To investigate the relationship between the channel design of tandem-andovoid (T&O) applicator and the doses to organs at risk (OARs) and target volume in three-dimensional brachytherapy for advanced cervical carcinoma.Methods The data on 15 patients with advanced cervical carcinoma treated with three-dimensional brachytherapy in our hospital from 2015 to 2016 were collected,and 30 randomly selected high-dose-rate titanium T&O plans were retrospectively studied.CT-guided,conformal brachytherapy plans were generated.To simulate T&O applicator,the tandem applicator was virtually compared with the T&O plans with the target volume and OARs remaining unchanged.The DVH parameters of the rectum,bladder,and sigmoid were compared using the paired t test.Results For T&O plans and tandem applicator plans,the mean D2cc of the rectum was 387.8±96.8 cGy and 340.8±88.1 cGy,respectively;the mean D2cc of the bladder was 443.2± 87.5 cGy and 719.4± 243.0 cGy,respectively;the mean D2cc of the sigmoid was 330.3±88.8 cGy and 383.1±105.6 cGy,respectively.In the T&O plans,the doses to the rectum,bladder,and sigmoid were within the limits (rectum:D2cc ≤ 500 cGy;bladder:D2cc ≤ 550 cGy;sigmoid:D2c ≤ 500 cGy),while D2cc of the bladder and sigmoid was higher or partially higher than the limits.T&O plans showed a significant reduction in bladder D2cc and sigmoid D2cc compared with the tandem applicator plans (all P＜0.05).Conclusions Compared with tandem applicator plans,plans using T&O applicator provide significant sparing of bladder and sigmoid tissues in three-dimensional brachytherapy for cervical carcinoma,but the toxicities require further investigation.

BACKGROUND:Calcium phosphate cements (CPCs) possess the bio-degradation and osteoconduction, and its final hydration product, hydroxyapatite, is the main inorganic constituent of bones. However, its poor mechanical property makes it unable to be used for repairing weight-bearing bone defects. OBJECTIVE:To develop a kind of bioactive bone cements with decent biomechanical property and biocompatibility. METHODS:6%silk fibroin aqueous solutions containing different concentrations of N-acetylcysteine (0, 10 and 25 mmol/L) were prepared. Each cement sample was prepared by mixing the curing liquid andα-tricalcium phosphate powder with the ratio of 0.4 mL:1 g;α-tricalcium phosphate powder mixed with ddH2O as control group. The compressive strength, setting time of the cements were measured. The crystal components of the cements were characterized using X-ray diffraction and the microstructure was observed using scanning electron microscope. MC3T3-E1 cel s were seeded onto the material in each group, and cel morphology was observed under scanning electron microscope at 24 hours. MC3T3-E1 cel s were cultured in the extract of each material, cel proliferation was detected at 1, 3, 5 and 7 days, and the lactate dehydrogenase level was detected at 1 and 3 days. RESULTS AND CONCLUSION:X-ray diffraction and scanning electron microscope showed that the final hydration products ofα-tricalcium phosphate in al specimens were hydroxyapatite. When the concentration of N-acetylcysteine was 25 mmol/L, the compressive strength of the material reached (49.39±1.68) MPa, with the initial setting time of (21.77±1.07) minutes and the final setting time of (31.88±1.69) minutes. There was no significant difference in cel morphology among cements. These results suggest that the cement containing N-acetylcysteine exhibites good biocompatibility and high mechanical strength.