BACKGROUND:Currently,different methods of model establishment have been derived from different injury modes of spinal cord injury.Traditional physical injury modeling methods have their own advantages and disadvantages,and there is a lack of more effective and stable animal models of spinal cord injury. OBJECTIVE:To establish a reproducible,controllable,trauma-free,low-mortality,more stable,widely applicable,and short-term postoperative care rat model of spinal cord injury. METHODS:Forty Sprague-Dawley rats with similar body mass and ages were randomly divided into a control group and an improved group,with 20 rats in each group.Animal models of spinal cord injury in the control group were constructed using a clip model method,while the improved group used a modified ligation method based on the compression method to make the spinal cord injury models using suture ligation based on fenestration.Postoperative comparisons were made between the two groups,assessing urination behavior,hematuria,pyuria(infection rate),mortality,scoliosis rate and Basso-Beattie-Bresnahan locomotor rating scale scores at 1,3,5,and 7 days after modeling. RESULTS AND CONCLUSION:Compared with the conventional modeling method,the modified ligation method based on the compression method resulted in faster recovery of urination behavior,lower hematuria rate,lower infection rate,lower mortality rate,lower scoliosis rate,and more concentrated and stable Basso-Beattie-Bresnahan scores(all below 2 points within 1 week).This proves that the modified ligation method based on compression is more suitable for the establishment of spinal cord injury models in rats.

Objective:To explore the effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.Methods:A total of 88 patients undergoing hemodialysis in dialysis center from June to December 2019 were randomly divided into intervention group (44 cases) and control group (40 cases) according to odd-even number method. Patients in both groups were treated with hemodialysis and basic treatment, and patients in intervention group were treated with self-management capability cluster intervention. The self-management ability, dialysis compliance and related complications were compared between the two groups before and after intervention. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test was used for intergroup comparison, and paired t-test was used for intragroup comparison. Results:There was no significant difference in self-management ability at baseline between intervention group and control group ( P>0.05). After 6 months, the total score of self-management ability ((68.61±10.16), (55.12±9.29)) and emotional processing ((13.42±2.89), (11.04±2.46)), executive self-care ((21.67±4.87), (16.71±3.59)), problem solving ((16.61±3.22), (12.03±4.61)), partnership ((14.26±3.64), (10.88±3.29)) were higher than those in the control group, and the differences were statistically significant ( t=7.112, 3.764, 4.739, 5.515, 5.834, all P<0.05). The total score of self-management behavior and the scores of four dimensions in the intervention group were significantly higher than those in the control group ( t=13.413, 5.432, 8.114, 1.910, 4.127, all P<0.05). There were significant differences between the intervention group and the control group in jumping behavior (9.09%, 22.50%) , shortening behavior (11.36%, 30.00%) , hyperkalemia (15.91%, 55.00%), heart failure (11.36%, 37.50%) and arteriovenous fistula occlusion (4.55%, 10.00%) ( χ2=4.095, 5.206, 17.571, 8.843, 5.127, all P<0.05). There were significant differences between the intervention group and the control group in urea clearance index, anemia improvement, blood phosphorus, parathyroid hormone level ( t=3.830, 4.558, -3.720, 6.481, all P<0.05). Conclusion:Self-management capability cluster intervention can improve the clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.

OBJECTIVETo assess the clinical value of the diagnostic laparoscopy in choosing treatment strategies for patients with gastric cancer.

METHODSRetrospective analysis was performed on clinical and pathological data collected from 2 023 patients undergoing gastric cancer surgery in the Zhongshan Hospital of Fudan University from 2009 to 2014. All the patients were diagnosed as gastric cancer by endoscopic biopsy and staged by imaging examination before surgery. During the diagnostic laparoscopy procedure, a small periumbilical incision was made and a pneumoperitoneum with COunder 10-15 mmHg was established through a port. A 10 mm trocar was put in, and the camera was inserted. Two 5 mm trocars were put in two ports which located in midclavicular line two fingers under the left and right costal margin and then the instruments were inserted. A thorough inspection included ascites, the abdominal cavity, liver, diaphragm, spleen, greater omentum, colon, small intestine, mesentery, adnexa (female) and pelvic floor. If the tumor located at the posterior part of the stomach, the gastrocolic ligament was opened in order to look for carcinomatosis in the omental bursa. The accuracy rate of diagnostic laparoscopy in diagnosing adjacent organ invasion and intra-abdominal metastasis was calculated, and the rate of adjusting treatment plans after diagnostic laparoscopy was also calculated.

RESULTSThere were 52.7%(1 067/2 023) of patients underwent diagnostic laparoscopy. The accuracy rate of diagnostic laparoscopy in evaluating adjacent organ invasion and intra-abdominal metastasis were 98.3%(1 049/1 067) and 98.1%(1 047/1 067) respectively. Besides, 14 patients with stage T4b and 32 with intra-abdominal metastasis, which were missed by imaging examination, were diagnosed by diagnostic laparoscopy. The treatment plans of 9.3% (99/1 067) of patients were changed after diagnostic laparoscopy, and 65 (6.1%) cases of non-therapeutic laparotomy were avoided. However, 18 cases of adjacent organ invasion and 20 cases of intra-abdominal metastasis were still missed by diagnostic laparoscopy, and 12 cases received non-therapeutic laparotomy.

CONCLUSIONDiagnostic laparoscopy has considerable value in assessing adjacent organ invasion and intra-abdominal metastasis and has great clinical significance in making precise treatment plans.

Abdominal Neoplasms ; diagnostic imaging ; secondary ; Digestive System ; pathology ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopes ; Laparoscopy ; instrumentation ; methods ; statistics & numerical data ; Laparotomy ; statistics & numerical data ; Male ; Neoplasm Invasiveness ; diagnostic imaging ; Patient Care Planning ; statistics & numerical data ; Retrospective Studies ; Stomach Neoplasms ; diagnostic imaging ; surgery ; Surgical Instruments ; Unnecessary Procedures ; statistics & numerical data

Objective To explore the relationship between Nestin expression level and prognosis in osteosarcoma,and to provide a new idea for treatment.Methods Thirty patient with osteosarcoma who had received treatment were included this study according to the criteria.HE staining was applied to evaluate the response to chemotherapy,meanwhile immunohistochemistry was applied to evaluate Nestin expression levels before and after chemotherapy.Kaplan Meier survival curve was drawn to analyze the outcomes.Results The response of chemotherapy was good in 17 patients and poor in 13.24 cases were strongly positive in Nestin staining,five were weakly positive,and one was negative.The expression level of Nestin in osteosarcona was correlated to the chemotherapy response and prognosis (P ＜ 0.05),while higher level of Nestin expression referred to poorer response of chemotherapy and lower overall survival rate.Conclusions The expression level of Nestin in osteosarcoma tissue is associated with the effect of chemotherapy and prognosis;higher expression level of Nestin indicates poorer prognosis and efficacy of chemotherapy.

Objective:To assess the influence of different surface treatment on the adhesion of the zirconia-veneering ceramic systems.Methods:28 zirconia specimens were divided into 4 groups(n =7) and treated by non-treatment(group A,the control),sandblaste(group B),hot-etching(group C) and sandblaste + hot-etching(group D).2 specimens randomly selected from each group were examined under SEM and XRD for the observation of surface structure.The veneering porcelain was layered on the remaining specimens of the 4 groups (n =5),then the shear strength of the interface was tested by a universal testing machine.Data were statistically analyzed by SPSS 13.0 software.Results:Different degrees of micro pore structure was observed on the zircomia surface of the 4 groups by SEM observation.The XRD analysis showed that all specimens emerged monoclinic phase.The shear bond strength of group A,B,C and D was (15.96 ± 3.44) MPa,(20.58 ± 2.21) MPa,(26.28 4-2.86) MPa and (22.51 ± 1.94) MPa respectively.group A vs group B,C and D,P ＜ 0.05;group C vs group A,B and D,P ＜ 0.05.Conclusion:The surface treatment of sandblaste,hot-etching and sandblasted + hot-etching can improve the shear bond strength of the zirconia-veneering ceramic systems,and the hotetching method is the most effective.

Ubiquitination is one of the most major post-translational modifications playing important role in regulation of intra-cellular proteins' stability, degradation, localization and biological activity. However, these proteins are difficult to be detected due to their low abundance, short half-life. In this study, ubiquitin-binding domains (UBDs) were constructed to purify the ubiquitinated proteins from Hep3B cells. Ubiquitinated proteins and sites were detected by LC-MS/MS. A total of 1 900 potential ubiquitinated proteins were identified. Among them, 158 ubiquitinated sites were identified, belonging to 102 proteins. Bioinformatics analysis revealed that the enriched pathways of ubiquitinated proteins were closely related to tumor occurrence and development. The dysfunction of ubiquitin-proteasome has a high correlation with cell signaling and extracellular matrix changing in tumor cells.

BACKGROUNDAccumulating evidence indicates that systemic inflammation response is associated with the prognosis of various cancers. The aim of this study was to investigate the neutrophil-lymphocyte ratio (NLR), which is one of the systemic inflammation markers, in the prognosis of hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE).

METHODSThe clinical data of 178 HCC patients who received TACE were retrospectively analyzed. The optimal NLR cutoff was determined according to the receiver operating characteristic (ROC) analysis. All patients were divided into NLR-normal group and NLR-elevated group according to the cutoff, and the clinical features of these two groups were comparatively analyzed. Meanwhile, the overall survival and disease free survival (DFS) were analyzed using the Kaplan-Meier method. The risk factors of postoperative survival were investigated using univariate and multivariate Cox regression analyses.

RESULTSThe optimal NLR cutoff was defined at 1.85 and 42 (23.6%) patients had an elevated NLR (NLR>1.85). The median survival time was 9.5 months (range 1-99 months). The clinical data between the two groups were comparable, except for a-fetoprotein. Follow-up results showed that the median survival of patients with normal NLR was 17.5 months (range: 1-99 months) compared with 8 months (range: 8-68 months) of patients with elevated NLR. The 1, 3 and 5-year overall survival of patients in the NLR-normal group and NLR-elevated group were 57.3%, 44.1%, and 27.2% and 42.1%, 19.6%, and 9.5% respectively (χ(2) = 194.2, P < 0.001). Similarly, the disease free survival also has a significant difference (χ(2) = 39.3, P < 0.001). Multivariate Cox regression analysis showed that a high NLR was an independent factor affecting the survival rate of HCC after TACE (P = 0.04).

CONCLUSIONPreoperative NLR was an important prognostic factor to predict the prognosis of patients with intermediate HCC treated with TACE.

Adult ; Aged ; Carcinoma, Hepatocellular ; pathology ; therapy ; Chemoembolization, Therapeutic ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Lymphocytes ; metabolism ; physiology ; Male ; Middle Aged ; Neutrophils ; metabolism ; physiology

Background Accumulating evidence indicates that systemic inflammation response is associated with the prognosis of various cancers.The aim of this study was to investigate the neutrophil-lymphocyte ratio (NLR),which is one of the systemic inflammation markers,in the prognosis of hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE).Methods The clinical data of 178 HCC patients who received TACE were retrospectively analyzed.The optimal NLR cutoff was determined according to the receiver operating characteristic (ROC) analysis.All patients were divided into NLR-normal group and NLR-elevated group according to the cutoff,and the clinical features of these two groups were comparatively analyzed.Meanwhile,the overall survival and disease free survival (DFS) were analyzed using the KaplanMeier method.The risk factors of postoperative survival were investigated using univariate and multivariate Cox regression analyses.Results The optimal NLR cutoff was defined at 1.85 and 42 (23.6％) patients had an elevated NLR (NLR＞1.85).The median survival time was 9.5 months (range 1-99 months).The clinical data between the two groups were comparable,except for α-fetoprotein.Follow-up results showed that the median survival of patients with normal NLR was 17.5 months (range:1-99 months) compared with 8 months (range:8-68 months) of patients with elevated NLR.The 1,3 and 5-year overall survival of patients in the NLR-normal group and NLR-elevated group were 57.3％,44.1％,and 27.2％ and 42.1％,19.6％,and 9.5％ respectively (x2=194.2,P ＜0.001).Similarly,the disease free survival also has a significant difference (x2=39.3,P ＜0.001).Multivariate Cox regression analysis showed that a high NLR was an independent factor affecting the survival rate of HCC after TACE (P=0.04).Conclusion Preoperative NLR was an important prognostic factor to predict the prognosis of patients with intermediate HCC treated with TACE.

Objective To investigate the application value of hepatectomy using Glissonean pedicle transection for hepatocellular carcinoma (HCC). Methods Clinical data of 54 patients with HCC undergoing radical hepatectomy in the First Affiliated Hospital of Medical College, Xi’an Jiaotong University from January 2002 to December 2012 were analyzed retrospectively. According to different surgical procedure, the patients were divided into hepatectomy with Glissonean pedicle transection group (Glisson group) and hepatectomy with Pringle maneuver (Pringle group) with 27 cases in each group. The informed consents of all patients were obtained and the ethical committee approval was received. In Glisson group, hepatectomy was performed after Glissonean pedicles were dissected and occluded. In Pringle group, hepatectomy was performed after the ifrst porta was occluded using Pringle maneuver. The intraoperative situation, the variation of liver function and incidence of complications after operation of two groups were observed. The patients received follow-up after operation and survival analysis was conducted. The comparison of measurement data between two groups was conducted using t test, the comparison of rates using Chi-square test or Fisher's exact probability test, and the survival analysis using Kaplan-Meier method and Log-rank test. Results The mean of intraoperative blood loss in Glisson group [(135±57) ml] was signiifcantly less than that in Pringle group[(248±87) ml] (t=-5.62, P<0.05). The total bilirubin (TB) level 1 d after operation in Glisson group [(23±5) μmol/L] was significantly lower than that in Pringle group [(34±5) μmol/L] (t=-8.08, P<0.05). In Glisson group, postoperative hemorrhage was observed in 2 cases and infection in 2 cases. In Pringle group, postoperative hemorrhage was observed in 3 cases, infection in 1 case, and bile leakage in 1 case. No signiifcant difference was observed in the incidence of postoperative complications between two groups (P>0.05). The 1-, 3-, 5-year cumulative survival rates were 89%, 50%, 39%in Glisson group and were 82%, 55%, 41%in Pringle group. The 1-, 3-, 5-year disease-free survival rates were 89%, 43%, 34%in Glisson group and were 82%, 47%, 41%in Pringle group. No signiifcant difference was observed in the cumulative survival rates and disease free survival rates between two groups (χ2=0.001, 0.011; P>0.05). Conclusion Hepatectomy using Glissonean pedicle transection is a safe, effective, and feasible surgical procedure for HCC with advantages of less blood loss, milder liver damage.

Objective To explore the correlative factors that affected the early clinical efficacy of surgical management of lumbar disc herniation.Method 208 cases of lumbar disc herniation were recruited since December 2007.The details of their therapy in different periods were compared and analyzed.Result The aggressive discectomy was the most powerful factor related to the better early clinical outcome.The patients with preoperative JOA score ＞ 17 were associated to the poor clinical outcome.The patients with postoperative JOA score ≥ 25 on 3 month and ≥ 24 on 1 year after operations were associated to better early clinlcal outcome.Conclusion The pre- and post-operative JOA score and aggressive discectomy were the factors affected the clinical outcome.