Objective To investigate the appropriate incision for intact specimen extraction during retroperitoneoscopic radical nephrectomy. Methods One hundred and nineteen patients in need of retroperitoneoscopic radical nephrectomy were randomized into two groups. One group of 60 patients received intact specimen extraction through a muscle-splitting abdominal incision. The second group of 59 patients received intact specimen extraction through a muscle-cutting lumbar incision. All procedures were performed by the same team of surgeons, and the intact specimens were extracted by the same surgeon. Standard operative features were measured and recorded (operative time, the time of specimen extraction, incision length, specimen weight, the time to get out of bed, the recovery time of gastrointestinal function, postoperative hospital stay, analgesia requirement, and complication rate). Results The two groups were matched in regard to patient age, body mass index, the maximum diameter of the kidney, and the stage of TNM (each P>0.05). There were significant differences between the abdominal incision group and lumbar incision group in terms of operative time (99±14 min vs 115±12 min; P=0.000), incision length (4.9±0.3 cm vs 5.3±0.4 cm; P=0.000), the time of specimen extraction (14±2 min vs 24±6 min; P=0.000), analgesia requirement (35±27 mg vs 52±29 mg; P=0.002), the time to get out of bed (20±2 h vs 21±4 h; P=0.016). The differences were not significant between the 2 groups in terms of the recovery time of gastrointestinal function (21±3 h vs 20±4 h; P=0.457), hospital stay (6±1 d vs 6±1 d; P=0.476), and specimen weight (469±181 g vs 459±169 g; P=0.776). There was no complication of incision in the 2 groups at 12 months′ follow-up (rang, 6 to 18 months). Conclusion A muscle-splitting abdominal incision for intact specimen extraction is more appropriate than a lumbar incision during retroperitoneoscopic radical nephrectomy, with small incision, little injury, short operative time, quick recovery, and less pain.

Objective To study the mutability of ultra sodium pyrosulfite intake on ultrastructure changes and spermatogonium mice testis.Methods Forty male Kunming mice were used.Experimental group had been exposed to ultra sodium pyrosulfite by fed for 10 days,and sodium pyrosulfite′s contaminated dose were 1% and 1‰.Mice were killed at 11~(th) day,and ultrastructure changes were observed under transmission electron microscopy(TEM) and the tests of sister chromosome exchanges(SCE) were made.Mmutation of ultra sodium pyrosulfite on spermatogonium of mice testis was judged.Results Compared with control group,there was a significant increase of SCE ratio in spermatogonium of testis in experimental groups(P

Objective To study the effect of hydrogen peroxide on microstructure of mice kidney and discuss the toxic effect on mice kidney.Methods Thirty healthy male mice of Kunming Genus were divided into 3 groups at random:control group and two experimental groups. Running water was fed to control group for 10 days while 0.3,3 g/L hydrogen peroxide running water readily prepared was fed to the experimental groups for 10 days. On the 10th day,the kidneys were taken out,and fixed in the fixation solutions,conventionally produced and stained.Finally,they were studied under the optical microscope.Results Experimental groups:in the kidney tissue cytoplasm of proximal convoluted tubule showed hydropic degeneration and vacuolation which depend on dose of hydrogen peroxide.Conclusion Toxic effect on mice kidney can be caused by hydrogen peroxide.

Contraindications ; Humans ; Portasystemic Shunt, Transjugular Intrahepatic

Objective To analyze negative lymph nodes of 34 non-small cell lung cancer(NCLC) patients with total correction by means of fluorescent quantitation PCR and immunohistcchemistry,and to form molecular bi- ology staging.Methods Clinical data and tissue samples of 193 lymph nodes were collected from 34 patients under- going resection for non-small cell lung cancer.Using fluorescent quantitation reverse transcription-polymerase chain reaction(RT-PCR) and immunohistochemistry method,lymph nodes were examined for CEA gene mRNA,P53 and CK to form molecular biology staging.All the patients were followed-up for an average of forty months.Results The CEAmRNA was identified in 21.7% (42/193) lymph nodes negative patients from 17 patients(17/34,50%); TMN staging was up-regulated in 8 patients;positive lymph nodes were increased in 9 patients.P53 and AE1/AE3 were identified 9.8%(19/193) from 11 patients,18.6 % (36/193)from 15 patients,separately;TMN staging was up-regulated in 2 patients of P53 examination and 5 patients of AE1/AE3 analysis;positive lymph nodes were in- creased in in 7 patients of P53 examination and 11 patients of AE1/AE3 analysis.There was obvious statistical sig- nificance in them,but the molecular biology staging based on the three markers was not an independent factor on re- currence and metasis of lung cancer.Conclusion CEAmRNA.P53 and AE1/AE3 analysis could find lung cancer micrometasis more sensitively to form molecular biology staging which was relative to the prognosis,but not an inde- pendent prognostic indicator.It might be good to the therapy strategy after operation.

[Abstract]? Objective? To study the experience of medical staff in conducting the interventions for delirium focusing on the promoting and hindering factors. Methods? Databases including Wanfang, CNKI, VIP, SinoMed, PubMed, EBSCO, Springer,CINAHL,EMBASE,Web of Science were searched and relevant qualitative studies were included and synthesized and analyzed after quality evaluation. Results? Totally 23 relevant articles were included and categorized into 8 themes based on research results: complex measure, psychological conflicts, heavy workload, fear and afraid, hopeless and helpless, pessimistic attitude, partners' support, organizational support. Conclusions? During the process of applying the early prevention and intervention for delirium, due to the complexity of the intervention measures, the workload increased and hinders the compliance of medical staff in the application of intervention for delirium. However, with the support from partners or the organization, the medical staff expressed their willingness to carry out the intervention measures. Hospital administrators should make full use of the promoting factors and actively overcome the obstacles so that the medical staff can effectively carry out the prevention and intervention measure for delirium and hence improve the nursing care quality for the patients.

Objective? To identify and analyze the problems existing in nurses' daily use of 3-Minute Diagnostic Interview for CAM-Defined Delirium (3D-CAM) and to provide a basis for intelligent development of 3D-CAM. Methods? From May to June 2018, totally 17 nurses who used printed 3D-CAM for daily evaluation of delirium in the Department of Orthopedics with a high incidence of delirium in a Class Ⅲ Grade A hospital in Beijing were selected by convenient sampling. Researchers observed and recorded the problems in nurses' daily use of 3D-CAM by task-centered walkthrough method till no new problems were found, i.e., the data were saturated and the data collection was completed. Results? The 17 orthopedic nurses used printed 3D-CAM for 107 evaluations of 57 patients. According to the walk-through research, it was found that the main causes of misuse of 3D-CAM were "man-made errors" (n=30), "misunderstanding of items" (n=7), "insufficient understanding of items" (n=30), and "incomplete/missing nursing records" (n=6). Conclusions? Nurses' use of printed 3D-CAM for delirium evaluation showed a high error rate and poor availability. Therefore, we need to enhance the training of delirium evaluation for nurses, conduct intelligent design and development of 3D-CAM and other delirium evaluation tools, and integrate them into the information system of hospitals so as to achieve the informatization, normalization and standardization of delirium evaluation.

Objective: Combining the aluminium content data of food in Henan Province with the data of children s food consumption, to evaluate probability of dietary aluminum exposure among primary school students. Methods: Database of nine types of aluminum containing food and their consumption among primary school students in Henan Province were established. The probability distribution of dietary aluminum exposure was calculated by Monte Carlo simulation using Crystal Ball 11.1.2.4 software, and the sensitivity analysis of exposure was conducted. Results: The average content of aluminum in fried bread stick was the highest, with the value of 150.89 mg/kg. The consumption of dietary aluminum was highest in steamed bun, with the value of 0.15 g. The average dietary aluminum exposure per kilogram of body weight was 1.99 mg per week of primary school students in Henan Province, accounting for 99.7% of the provisional tolerable weekly intake (PTWI). The 95th percentile of aluminum exposure per kilogram of body weight per week was 6.16 mg, which was three times of that of PTWI. Nearly 13.22% of primary school students had dietary aluminum exposure higher than PTWI. Among all kinds of food, the average aluminum exposure of fried bread stick per kilogram of body weight per week was the highest 1.19 mg. Aluminum content in fried bread stick accounted the highest proportion of average dietary aluminum exposure among primary school students. Conclusion The average dietary aluminum exposure level of primary school students in Henan Province is close to the PTWI established by JECFA, with the high consumption population exceeds the PTWI. Measures should be taken to reduce the dietary aluminum exposure risk of primary school students.

AIM To explore the effects of Zishui Qinggan Decoction on the mouse model of depression induced by chronic restraint stress(CRS)via ERK/GSK3β/CREB/BDNF signaling pathway.METHODS Except for those of the blank group,the mice of other groups were induced into depression models by CRS,and divided into the model group,the fluoxetine hydrochloride group(10 mg/kg)and the low,medium and high dose Zishui Qinggan Decoction groups(8.835,17.670 and 35.340 g/kg)for the corresponding drug intervention and simultanous CRS treatment.The mice had their sugar water preference experiment and behavior experiment on the 7th and 14th day after administration;the observation of the hippocampal morphological changes by HE staining,the detection of the superoxide dismutase(SOD)activity and malondialdehyde(MDA)level in serum by kits,the detection of levels of serum 5-hydroxytryptamine(5-HT),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)by ELISA,the detection of the hippocampal mRNA expressions of BDNF,TNF-α and IL-1β by RT-qPCR method,and the detection of the hippocampal protein expressions of ERK1/2,p-ERK1/2,GSK3β,p-GSK3β,CREB and BDNF by Western blot method 14 days after administration.RESULTS Compared with the model group,after 14 days of administration,both fluoxetine hydrochloride group and medium-dose Zishui Qinggan Decoction group displayed increased preference rate of sugar water(P<0.01),shortened immobility time of tail suspension and forced swimming(P<0.01),improved hippocampal damage of nerve cells,decreased levels of serum MDA,TNF-α and IL-1β(P<0.05,P<0.01),increased SOD activity and 5-HT level(P<0.05,P<0.01),decreased hippocampal mRNA expressions of TNF-α and IL-1β(P<0.01),and decreased expressions of BDNF mRNA and p-ERK1/2,p-GSK3β,CREB and BDNF proteins(P<0.05,P<0.01).CONCLUSION Zishui Qinggan Decoction can improve the depression-like behaviors in mice exposed to CRS,and its mechanism may be related to the regulation of hippocampal ERK/GSK3β/CREB/BDNF signaling pathway.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood