Infection is an essential factor in chronic wound disunion. With the increasing number of patients with chronic diseases in the aging society, the number of patients with chronic wounds increases. It caused a heavy social burden. The proper cleaning method and cleaning fluid play a key role in chronic wound healing. In this paper, the concepts, classification, mechanism of different cleaning fluids, and their effects on chronic wounds were reviewed, which is expected to help health professionals to choose cleaning methods and cleaning fluids scientifically. It was supposed to provide significant guidance for chronic wound cleaning.

Objective To evaluate the therapeutic effect of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty in the treatment of Chiari malformation type Ⅰ.Methods The clinical data of 45 Chiari malformation type Ⅰ patients who were treated with small bone flap craniotomy decompression of posterior cranial fossa and duraplasty were retrospectively analyzed,31 cases among them with syringomyelia.Results According to Tator etc.standard,1 month after surgery,the excellent in 30 cases,good in 15 cases.Follow up from 6 months to 6 years,the excellent in 37 cases,good in 8 cases.Among 31 patients with syringomyelia,26 cases were syringomyelia subsided,5 cases were not obvious change.Conclusion The small bone flap craniotomy decompression of posterior cranial fossa and duraplasty can make the craniocervical decompression,and has obvious effect of treating syringomyelia,is safe and effective in treatment of Chiari malformation type Ⅰ.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

Objective To investigate the expressions of TESTIN gene and Caspase-3 protein and thier relations with the clinicopathological features and prognosis of esophageal squamous cell carcinomas(ESCC). Methods The expressions of TESTIN and Caspase-3 in 50 ESCC tissues and paracancerous tissues (＞5 cm apart form the ESCC tissue) were detected by immunohistochemistry.The expression of TESTIN in 65 matched-pairs of ESCC tissues was detected by Western blotting and RT-PCR. The association of TESTIN and Caspase-3 with clinicopathological features and prognosis of ESCC were analyzed. Results The immunohistochemistry examination showed that the positive rates of TESTIN protein [30. 0% (15/50)] and Caspase-3 protein [24.0% ( 12/50)] were significantly lower in ESCC tissues than those in paracancerous tissues [(84. 0% (42/50) and 94. 0% (47/50),respectively, P＜0.01)]. The mRNA level of TESTIN was down-regulated in ESCC tissues (P＜0.05). Whereas the protein level of TESTIN was down-regulated in 45 (69.2%) of 65 ESCC tissues in comparison with paracancerous tissues. TESTIN expression was positively correlated with the differentiation of ESCC, but not associated with gender, age, tumor size, TNM stage and lymph node metastasis. There was a positive correlation between TESTIN and Caspase-3 in protein expressions (P＜0. 05). Patients with negative expression of TESTIN had lower survival rate compared to those with positive expression (P＜0. 05). Conclusions The positive relation between low-expression of TESTIN and Caspase-3 implicates that both are involved in the development of esophageal squamous cell carcinogenesis, and TESTIN might be a novel ESCC marker with prognostic significance.

ObjectiveTo explore the changes of serum high sensitive C-reaction protein (HS-CRP) and matrix metalloproteinase-9 (MMP-9) in patients with acute coronary syndrome (ACS) and their effects in nursing.Methods103 ACS patients, including 56 cases of unstable angina (UA)) and 47 cases of acute myocardial infarction (AMI), and other 40 persons (no abnormal results in coronary artery angiography, selected as control group) were examined for serum levels of HS-CRP and MMP-9. The difference among the groups was analyzed.ResultsThe HS-CRP levels of UA group, AMI group and control group were (3.87± 0.76 )g/L, (4.12 ±0.67)g/L and (1.67±0.38)g/L respectively; MMP-9 were (113.25±7.76)ng/ml, (193.09±25.87)ng/ml and (42.05±3.81)ng/ml respectively. The concentrations of HS-CRP and MMP-9 of ACS patients were significatly higher than those of the control group (P<0.01).ConclusionThe changes of HS-CRP and MMP-9 concentrations of ACS patients are remarkable, and may be as the markers to instruct nursing works.

Amygdala ; drug effects ; metabolism ; Animals ; Conditioning (Psychology) ; Morphine ; adverse effects ; Rats ; Receptors, Opioid, kappa ; metabolism

AIMTo detect the changes of inducible nitric oxide synthase (iNOS) expression in liver following ischemia/reperfusion (I/R) of hindlimbs and to elucidate their significance.

METHODSI/R was established using the occlusion of the femoral arteries for 4 h and reopening for 2-24 h in rats. The expression of iNOS mRNA, and iNOS protein and the nitrotyrosine (NT), a marker of peroxynitrite (ONOO-), in liver tissue were detected with reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical technique, respectively. The liver superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were spectrophotometrically measured. The observation of pathologic changes of liver was made following the inhibition of iNOS by aminoguanidine (AG).

RESULTSCompared with control groups, the relative expression level of iNOS mRNA significantly increased in I/R group. There were more iNOS positive hepatocytes and more NT positive hepatocytes in I/R group than control groups. The contents of MDA markedly increased, while the activity of SOD significantly decreased in I/R group, compared with those in the control groups. The pathologic changes of rat liver became milder in I/R group following the inhibition of iNOS by AG.

CONCLUSIONThe expressions of iNOS mRNA and protein in liver are significantly upregulated, excess induction of iNOS-NO is contributed to the liver injury during the I/R of hindlimbs.

Animals ; Guanidines ; pharmacology ; Hindlimb ; blood supply ; Liver ; blood supply ; metabolism ; Male ; Malondialdehyde ; analysis ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; Superoxide Dismutase ; analysis

Objective To evaluate the incidence and significance of perineural invasion (PNI) in cervical cancer. Methods Retrospective chart review of patients with cervical cancer (stages Ⅰa2-Ⅱb) who underwent radical hysterectomy and pelvic lymphadenectomy from 2007 to 2012. To evaluate the incidence and significance of PNI in cervical and uterine tissues by microscopic examination. Results A total of 238 patients were included, 9.2% (22/238) patients with PNI in the cervical stroma. Patients with PNI were more likely to have adverse histopathologic features, including lymphoma vascular space invasion, parametrical invasion, depth of invasion, tomor size and lymph nodes metastases (all P<0.05). PNI were independent of age, international federation of gynecology and obstetrics (FIGO) stage, histopathology type and grade, and positive vaginal margin (all P>0.05). Patients with PNI had shorter disease-free and overall survival (P=0.002 and P=0.008, respectively). On multivariate analysis, risk factors for recurrence and death included parametrical invasion and depth of invasion (P<0.05). Similarly, risk factors for recurrence included lymph nodes metastases (P=0.024). However, PNI was not identified as an independent risk factor for either recurrence or death (P>0.05). Conclusions PNI exists in early cervical cancer. PNI is associated with tumor size, depth of invasion, parametrical invasion, lymphoma vascular space invasion and lymph nodes metastases. PNI represente a decreasing disease-free and overall survival in patients with early-stage cervical cancer, and is independently associated with multiple high-risk factors, which be informed management decisions regarding adjuvant therapy.

Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .

BACKGROUND:Vacuolar proton pump on the cytoplasmic membrane of osteoclasts is an essential enzyme for bone histolysis. Vacuolar proton pump inhibitor can significantly inhibit the in vitro cultured osteoclasts.
OBJECTIVE:To observe the effect of proton pump inhibitor FR167356 on the osseointegration of dental implant of osteoporosis rabbits.
METHODS:A total of 24 female Japanese white rabbits aged 5 months were randomly divided into three groups:ovariectomy (OVX) group, FR167356 group and shamed operation group. Each group contained eight rabbits. Rabbits of OVX group and FR167356 group received a surgical removal of bilateral ovaries, while rabbits of sham operation group had a surgical removal of equivalent adipose tissue beside the ovaries. Two titatium implants (8 mm long, 3.3 mm diameter) were instal ed into bilateral proximal tibias respectively 12 weeks after OVX operation. FR167356 was administrated by muscle injection in FR167356 group;meanwhile equivalent normal saline was administrated in the OVX group and sham operation group. At 4 and 8 weeks after implantation, animals in each group were sacrificed respectively for X-ray imaging, histomorphology, and mechanical test.
RESULTS AND CONCLUSION:X-ray examination showed that at 4 weeks, the implants in the OVX group exhibited a high resistance projective image, low density image of clearance screw thread, and clear boundaries between bone tissue than the other two group. At 12 weeks, the density of the clearance screw thread in sham operation group and FR167356 group was more closer to the surrounding bone tissue when compared with the OVX group, the boundaries between the implant and the surrounding bone tissue disappeared more apparently, and no significant differences were found between the two groups. Histomorphology observation revealed that, at 4 weeks after implantation, new bone with porous and trabecular extended along the implant surface to the root direction in FR167356 and sham operation groups. There were no significant differences in the two groups. At 12 weeks after implantation, the bone mass around implant was increased greatly and the trabecular grew thicker. This phenomenon was not observed in the OVX group. Mechanic test showed that at 4 and 12 weeks after implantation, the maximum pul out force in the OVX group was significantly lower than that in the other two groups. Local application of FR167356 can significantly improve the osseointegration of the implant in osteoporosis rabbits.