Objective:To explore the effect of self-designed fixed support in the postoperative nursing of abdominal flap repair.Methods:From January 2016 to December 2019, 47 patients with hand tissue defects undergoing abdominal skin flap repair in Shajing People′s Hospital, Guangzhou Medical University were divided into control group (23 cases) and observation group (24 cases) by random digits table method. The control group was treated with traditional methods, and the observation group was treated with self-designed fixed support. The wound healing of abdominal flap, the wound tearing after flap operation, pedicle ulcer after flap operation and the patients' nursing satisfaction were compared between the two groups.Results:There were 7 cases of primary healing and 16 cases of secondary healing in the control group, 18 cases of primary healing and 6 cases of secondary healing in the observation group. The difference between the two groups was statistically significant ( χ2 value was 9.368, P<0.01). The incidence rate of the wound tearing after flap operation was 26.1% (6/23) in the control group and 0 (0/24) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 7.177, P<0.05). The incidence rate of pedicle ulcer after flap operation was 69.6% (16/23) in the control group and 33.3% (6/23) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 6.170, P<0.05). The patients' nursing satisfaction was (76.8±8.4)points in the control group and (90.4±6.5) points in the observation group.The difference between the two groups was statistically significant (t value was -4.640, P<0.01). Conclusions:The use of fixed support after the operation of abdominal flap is helpful to the wound healing, reduce the occurrence of wound tear and pedicle ulcer, and improve the satisfaction of nursing, which is worth popularizing.

Objective:To study the efficacy and safety of Hassab operation combined with either radiofrequency ablation(RFA) or liver resection in treatment of liver cancer associated with portal hypertension.Methods:A retrospective analysis was conducted on the clinical data of patients with primary liver cancer associated with portal hypertension operated at the Department of General Surgery of Beijing Ditan Hospital from June 2013 to June 2015. These patients were divided into the RFA combined with Hassab operation group and the liver resection combined with Hassab operation group according to the surgical procedures. The general patient information, operation time, intraoperative blood loss, intraoperative blood transfusion, postoperative hospital stay, postoperative complications and the 1-, 3-, and 5-years cumulative survival rates and recurrence-free survival rates were compared.Results:Of 53 patients who were included in the study, 30 patients were in the RFA combined with Hassab operation group (including 28 males and 2 females, average age 46.3 (27.0~64.0) years, and 23 patients in the liver resection combined with Hassab operation group (including 20 males and 3 females), average age 44.7(33.0~59.0) years. There were no significant differences in the general patient information including age, gender, maximum tumor diameter, preoperative laboratory tests (including blood routine, liver function, tumor markers), and Child-Pugh classification between the two groups (all P>0.05). Intraoperative blood loss in the RFA combined with Hassab operation group was significantly less than those in the liver resection combined with Hassab operation group [(401.67±183.12) ml vs (552.17±333.88) ml, P<0.05]. There were also no significant differences between the two groups in operation time, blood transfusion during operation, postoperative hospital stay, and postoperative complications ( P>0.05). The incidence of severe postoperative complications (Clavein-Dindo grade ≥ IIIb) in the liver resection combined with Hassab operation group was 47.8% (11/23), which was significantly higher than the 20.0% (6/30) in the RFA combined with Hassab operation group ( P<0.05). The 1-, 3-, and 5-year cumulative survival rates of patients in the RFA combined with Hassab operation group were 82.8%, 49.9%, and 33.2%, respectively, while the corresponding survival rates of patients in the liver resection combined with Hassab operation group were 81.0%, 58.2%, 43.7%, respectively. There was no significant difference between the two groups ( P>0.05). The recurrence-free survival rates of patients in the RFA combined with Hassab operation group at 1-, 3-, and 5-years after surgery were 79.2%, 38.8%, and 21.6%, respectively. The corresponding recurrence-free survival rates of patients in the liver resection combined with Hassab operation group were 76.4%, 41.7%, and 27.8%, respectively, and there was no significant difference between the two groups ( P>0.05). Conclusion:RFA combined with Hassab operation was safe and efficacious to treat primary liver cancer associated with portal hypertension.

Objective Evaluation of cerebral blood flow in patients with transient ischemic attack (TIA) using cerebral CT perfusion imaging.Methods CT perfusion scan was performed on a consecutive series of 20 patients with clinical definite TIA.Following their initial CT scan at acute stage of TIA, patients underwent two repeat CT perfusion scanning of region of interest at acute stage and one month after symptom remission.Results Mild to moderate decrease in regional cerebral blood flow (rCBF) and unchanged or mildly decrease in regional cerebral blood volume (rCBV) were observed at acute stage in the majority cases.Normal cerebral perfusion was found in 12 cases and mild to moderate decrease of rCBF in 8 cases one month after TIA.During the one-year follow-up period, all of 12 cases with normal cerebral perfusion did not have recurrence while among 8 cases with mild to moderate decrease of rCBF at initial scan, 6 cases had recurrent TIA or cerebral infarction and 2 cases did not have recurrence.Patients with more severe cerebral perfusion defects usually had a shorter interval time between two attacks.Conclusions Intensive intervention should be performed on patients with severe and long lasting decrease of cerebral perfusion.

Objective:To evaluate the feasibility of CT radiomics method in predicting outcomes of simultaneous pulmonary nodules in breast cancer patients after treatment.Methods:Patients with breast cancer confirmed by pathology and with simultaneous pulmonary nodules (diameter>5 mm, number≤5) detected by preoperative CT were retrospectively enrolled in this study. Eighty female patients were included (median age: 52, quartile range: 45, 61). The pulmonary nodules (median size: 6.0 mm, quartile range: 5.5, 7.2 mm) were classified into stable group (without change over 2 years) and change group according to follow-up CT findings. The change group was further divided into improved group and progressive group. Eventually, 54 cases were in the stable group, 26 cases were in the change group. One hundred and five texture features were extracted using the python-based pyradiomics package based on preoperative CT images. Stepwise regression was used to exclude features without significant difference in predicting changes of pulmonary nodules. Classifiers model and 5 fold cross validation method were used to obtain the highest performance in predicting outcomes of pulmonary nodules. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance of the model.Results:After features exclusion and selection, three radiomics features were used to establish classifiers between stable group and change group. It was showed that the linear discriminate analysis was the optimal model with the specificity, sensitivity, accuracy and area under the ROC curve (AUC) as 0.980, 0.460, 0.813 and 0.770 respectively. One radiomics feature was chosen to establish classifiers between improved group and progressive group. The coarse gaussian support vector machine (CGSVM) was the optimal model, with the specificity, sensitivity, accuracy and AUC as 0.540, 0.920, 0.713 and 0.880 respectively.Conclusions:CT radiomics analysis has the potential to predict the outcomes of simultaneous indeterminate pulmonary nodules in breast cancer patients after treatment, and it may contribute to preoperative treatment and postoperative follow-up planning.

Cholangiocarcinoma is a group of highly invasive and heterogeneous biliary malignancies originating from any part of the biliary tree. At present, the most ideal treatment is still radical surgery.Gemcitabine combined with cisplatin (gem-cis) has been recognized as the standard first-line chemotherapy regimen for patients with unresectable, advanced or metastatic disease.In recent years, with the proposal of precision medicine and the development of next-generation sequencing technologies, A large number of important cholangiocarcinoma targets have been discovered, such as FGFR, IDH, VEGFR, BRAF, MET, etc., and the research on corresponding target drugs is booming.By referring to relevant literature and data, combined with domestic and foreign clinical trials, this paper reviews the important targets of cholangiocarcinoma and the latest progress of targeted drug therapy.

Objective To discuss characteristics of height growth such as Peak Height Velocity (PHV) and Age at Peak Height Velocity (PHA) during adolescence,and to compare the results with other research findings.Methods Primary and middle school students' annual physical examination data of Zhongshan in 2005-2010 was used.The height velocity by age,PHV,PHA,height velocity by PHA were calculated.Results The average peak height velocity boys was ( 10.03 ± 1.67 ) cm/yr.and that of the girls was ( 8.39 ± 1.05 ) cm/yr.Both findings were close to the results from previous similar findings.The average age at which peak height velocity reached 12.28± 1.30 years for boys and 10.78 ± 1.04 years for girls,both lower than the previous findings.The correlation coefficients,between height level and PHA were -0.357 (P＜0.001) for boys and -0.338 (P＜0.001) for girls.Conclusion The height levels were positively related to the height velocity before PHA.The Zhongshan students' PHA was lower than the Beijing,Shanghai and Shenyang students,also lower than American and Britain students',but their PHVs were similar.

OBJECTIVETo evaluate the method for expanding Valpha24 natural killer T (NKT) cells with alpha-galactosylceramide (alpha-GalCer) ex vivo.

METHODSMononuclear cells (MNCs) isolated from adult peripheral blood or umbilical cord blood (UCB) were divided into three groups. In Group A1 (n = 5), CD34+ progenitorderived dendritic cells were differentiated in a cytokine-supplemented culture system from cord blood and acted as antigen presenting cells (APC) to induce the expansion of cord blood Valpha24 NKT cells in presence of alpha-GalCer; in Group A2 (n = 5), adult peripheral monocyte-derived dendritic cells (Mo-DC) were used as APC to induce the expansion of adult peripheral NKT cells in presence of alpha-GalCer; whereas in Group B (n = 16), alpha-GalCer was added into adult peripheral MNCs culture system without additional DCs. Cytokine-produce were measured by ELISA, and NKT cells' proliferation ability, cytotoxicity, and suppressive effect on mixed lymphocyte reaction (MLR) were examined by MTT assays.

RESULTSValpha24 NKT cells in Group A1, A2, and B were expanded up to 128 (95-207), 250.5 (179.6-790.6), and 326 (101-2 136) -fold by day 12, respectively. Adult NKT cells expanded in Group B were markedly better than those in Group A1 (P = 0.038). When stimulating by PMA, the NKT cells had a 3-day stimulate index of 1.80 +/- 0.41; and the secretion ratio of IL-4 to IFN-gamma of UCB or adult peripheral blood NKT cells were 0.30 +/- 0.13 and 0.28 +/- 0.18; and the ex vivo antitumor effect of expanded NKT cells were found in cell line HL60, KG1a, and Raji except for K562; and the suppressive effect of expanded NKT cells or the culture supernatant on MLR were confirmed.

CONCLUSIONSAlpha-GalCer can facilitate the rapid shorttime expansion of Valpha24 NKT cells in presence of IL-2 and IL-15. These expanded NKT cells, kill tumor cell lines, and inhibit can massively excret IL-4 and IFN-gamma allogeneic T-cell response.

Antigens, CD34 ; analysis ; immunology ; Cytotoxicity Tests, Immunologic ; Dendritic Cells ; immunology ; Galactosylceramides ; immunology ; HL-60 Cells ; pathology ; Humans ; K562 Cells ; pathology ; Killer Cells, Natural ; cytology ; immunology ; metabolism ; Lymphocyte Activation ; drug effects ; Receptors, Antigen, T-Cell, alpha-beta ; immunology ; T-Lymphocyte Subsets ; cytology ; immunology ; metabolism

OBJECTIVETo investigate the outcome of repairing pelvic autonomic nerve defects with the tissue-engineered nerve, in order to provide a new method and experimental evidence for solving sexual disturbance induced by pelvic autonomic nerve injury after radical resection of rectal carcinoma.

METHODSBone marrow stromal cells (BMSCs) were purified with density gradient centrifugation. A 10 mm defect of hypogastric nerve was created in 9 Beagle dogs and the 18 hypogastric nerves were randomly divided into three groups. Group A: nerve defects bridged with copolymer of lactic and glycolic acids (PLGA) tube containing BMSCs and collagen protein sponge. Group B: with PLGA tube only containing collagen protein sponge. Group C: with autologous nerve graft. The effect of nerve recovery was evaluated by morphology, HE staining, neurofilament immunohistochemistry staining, electron microscope scanning and measurement quantity of new axon 12 weeks after the transplantation.

RESULTSTwelve weeks after the transplantation, degradation of PLGA tubes showed in group A and group B. The nerves regenerated through defect area to distal end. The density of regeneration nerve fiber in group A and group C were better than that in group B. The difference was significant between group A or group C and group B (P<0.05), and no significant difference was observed between group A and group C(P>0.05).

CONCLUSIONTissue-engineered nerve, which is constructed by BMSCs mixed with collagen protein sponge and PLGA tube, can be used to bridge and repair the pelvic autonomic nerve defect.

Animals ; Artificial Organs ; Cell Differentiation ; Cells, Cultured ; Dogs ; Male ; Mesenchymal Stem Cell Transplantation ; Motor Neuron Disease ; surgery ; Nerve Regeneration ; Nerve Tissue ; Pelvis ; innervation ; Tissue Engineering ; methods

The aim of this study was to investigate the homing characteristics of bone marrow cells in leukemia mice after allogenic bone marrow transplantation with different conditioning regimens on the basis of a leukemia mouse model. Allogenic bone marrow transplantation was performed after three different kinds of conditioning regimen, including nonmyeloablative conditioning regimen (5 Gy (60)Co γ ray total body irradiation, A group), radiotherapeutic myeloablative conditioning regimen (9 Gy (60)Co γ ray total body irradiation, B group) and chemotherapeutic myeloablative conditioning regimen (large dose chemotherapy, C group). In the recipient mice, the nucleated cell number in peripheral blood, bone marrow and spleen was counted, the percentage of positive cells capable of connecting with FITC labeled anti-mouse H-2K(b) antibody was detected by flow cytometry and the homing ratio in bone marrow and spleen was calculated at 24, 48, 72, 96 h after bone marrow transplantation. The results showed that donor myeloid cells displayed homing and then mobilization (going out of home) in group A; homing, mobilization, and rehoming in group B and C, and there was a little delay of homing in the spleen in group C. In bone marrow, the homing efficiency of A group was the highest in early period and the lowest [(0.90 ± 0.09)%] in the fourth day with the mobilization of myeloid cells (P < 0.05), and the homing efficiency of B and C groups was lower in the early period and the highest [(2.17 ± 0.26)%, B group] in the fourth day with the rehoming of myeloid cells (P < 0.05). In spleen, the homing efficiency was similar to that in bone marrow and there still was a little delay in C group. It is concluded that the homing ratio is high in the early period and decrease obviously in 72 h after bone marrow of leukemia mice treated with nonmyeloablative conditioning regimen. The homing ratio is low in the early period and increases obviously in 72 h after bone marrow of leukemia mice treated with radio-or chemotherapeutic myeloablative conditioning regimens. The homing ratio does not obviously change between the early period and 72 h after bone marrow of leukemia mice treated with chemotherapeutic myeloablative conditioning regimen, and lies between group A and B.
Animals ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; methods ; Cell Count ; Female ; Graft Survival ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Spleen ; cytology ; Transplantation Conditioning ; methods ; Whole-Body Irradiation

OBJECTIVETo study the effect of Itk down regulation on Jurkat cell proliferation and inflammatory cytokines production, and provide useful data for Itk as an attractive target for potential drugs.

METHODSThree shRNAs against different region of Itk were constructed and cotransfected with pEGFP-C1-hItk. The shRNA, which can knock down Itk, was selected and packed into lentivirus. After Jurkat cells were transfected with shRNA lentivirus, the change of Itk protein expression, cell proliferation and cytokines production was observed.

RESULTSItk mRNA was reduced about 55% in Jurkat cells transfected with Itk-shRNA1, compared with that in control cells shRNAnon (P < 0.05). Knocking down Itk expression had a profound inhibitory effect on Jurkat cell proliferation. In addition, there was a substantial decrease in level of cytokines, such as IL-2, IL-5, IL-10 and IFN-gamma, produced by cell transfected with Itk-shRNA1.

CONCLUSIONKnocking down Itk expression can inhibit Jurkat cell proliferation and inflammatory cytokines production.

Animals ; Cell Proliferation ; Cytokines ; genetics ; immunology ; Down-Regulation ; Gene Knockdown Techniques ; Humans ; Interleukin-10 ; genetics ; immunology ; Interleukin-2 ; genetics ; immunology ; Interleukin-5 ; genetics ; immunology ; Jurkat Cells ; cytology ; enzymology ; immunology ; Mice ; Protein-Tyrosine Kinases ; genetics ; immunology