Objective To assess the expression of T cell subset in patients with hepatitis B virus-associated primary liver cancer (HBV-PLC) and its influence on the clinical outcome.Methods 136 cases with PLC were selected, and divided into HBV-PLC group (78 cases) and non-HBV-PLC group (58 cases) according to HBV infection.The percentage of CD4+T cells, CD8+T cells and Treg cells in serum was tested by flow cytometry.After 6 months of follow-up, HBV-PLC patients were divided into death group and survival group.Binary logistic regression analysis was performed to explore the factor and degree affecting clinical outcome of HBVPLC patients.Results As compared with non-HBV-PLC group, dysregualted T cell subset was observed in the HBV-PLC group, percentage of CD4+T cells and Treg cells in HBV-PLC patients was higher (P＜0.05), while CD8+T cell percentage was decreased (P＜0.05).The percentage of CD4+T cells and Treg cells was higher in death group than survival group (P＜0.05), but CD8+T cell percentage was lower than that of survival group (P＜0.05).T-lymphocyte subset (CD4+T cells and Treg cells) was a strong risk factor for adverse clinical outcome of HBV-PLC (OR values were 3.765 and 2.238, respectively, P＜0.05), but CD8+T cell was a protective factor (OR value was-3.537, P＜0.05).Conclusion Obvious dysfunction of T cellular immune function exists in HBV-PLC patients, and T cell subset may be a predictive factor for clinical outcome of HBV-PLC patients.

Objective: To investigate the sources of meaning in life of the elderly in the community. Methods: The phenomenological approach was conducted in Guangzhou Yuexiu Liurong community health service center and Shouxing nursing home in Baiyun District, a total of 21 elderly were interviewed by semi-structured in-depth interviews. Interviews data were analyzed by Nvivo11. Results: The elderly in the community were less concerned about the meaning in life. The level of meaning in life ranges from nothing to high, and some elderly had not explored it yet. Sources of meaning in life for elderly were quite different from when he was young: one valued work, earn money and self-improvement more when young, but as the growth of age, one would pay more attention to family and health. The sources of meaning in life included suffering, autonomy, family, make contributions and faith. Conclusion In the future, the sense of meaning in life of the elderly can be enhanced from the perspective of individuals, families and society by identifying the sources of meaning of the elderly.

Objective To explore the risk factors of nosocomial infections to provide a reference for prevention and control of nosocomial infection.Methods The data of 680 patients with nosocomial infection in this hospital from January 2015 to December 2016 were retrospectively collected.The characteristics of nosocomial infection were analyzed from the aspects of age,hospitalization department,infection site,etc.Results A total of 680 cases of nosocomial infection accounted for 1.67％(680/40 657) of all hospitalization patients,including 316 cases(nosocomial infection rate was 2.47％) of 61-80 years old.The infection rate was the highest in ICU(24.90％),followed by the nephrology department(4.99％).For infection sites,the maximal cases-times in infection site was lower respiratory tract(413 case-times),followed by urinary tract and superficial incision(each 68 case-times).The pathogenic detection rate was 45.03％,and 190 strains of pathogens were detected.The top five places were Escherichia coli(47 strains),Klebsiella pneumoniae(28 strains),Pseudomonas aeruginosa (23 strains),Staphylococcus aureus (22 strains) and Bauman Acinetobacter (16 strains).Logistic regression analysis showed that age larger than 60 years old,hospitalization time longer than 60 d,indwelling urinary catheter,peripherally inserted central catheter(PICC),tracheotomy and enteral nutrition were the risk factors for nosocomial infection occurrence.Conclusion Hospital should put the emphasis on preventing nosocomial infection of lower respiratory tract and strengthen the nosocomial infection management of key departments like ICU.

Objective To explore the effect of the Internet technology′s application on the hand hygiene compliance of medical staff. Methods Establishing Internet+hand hygiene management model to implement Internet based hand hygiene supervisory and reminding, Internet based hand hygiene publicity and education, and Internet based hand hygiene feedback and communication. This model was applied in Guangdong Provincial Dermatology Hospital to intervene the hand hygiene related activities. Before and after the intervention, the hand hygiene compliance of medical staff in the trial hospital was observed with WHO hand hygiene monitoring table by directly manual observation. Thereafter, the changes of hand hygiene compliance before and after the intervention were compared based on the statistical analysis of test results. Results With the application of Internet+hand hygiene management model, the hand hygiene compliance of medical staff increased from 41.75% (324/776) before the intervention to 72.14% (554/768) after the intervention, and the difference was statistically significant (χ2=145.264, P<0.01). The hand hygiene compliance of both doctors and nurses was significantly increased (doctors: χ2=94.784, P<0.01;nurses:χ2=58.798, P<0.01). In all the five indications, i.e., before patient care, before an aseptic task, after exposure to blood/body fluids, after patient care, and after environmental contact, the hand hygiene compliance was 35.42%(68/192), 63.33%(38/60), 84.38%(54/64), 44.83%(130/290), and 20.00%(34/170) respectively before the intervention;it was 65.38%(102/156), 83.33%(120/144), 95.45%(105/110), 68.52%(148/216), and 55.63%(79/142) after the intervention; and the difference before and after the intervention was statistically significant (χ2=6.305-42.529;P<0.01 or 0.05). Most of the medical staff of the trial department supported this model. Conclusions Internet+ hand hygiene management model could significantly improve the hand hygiene compliance of medical staff and were very popular. And, the model is worth of application in more hospitals.

Objective To assess the quality of randomized controlled trials (RCTs) of delirium prevention of elderly published in China.Methods The literatures from China National Knowledge Infrastructure(CNKI),WANFANG Data and VIP Database for Chinese Technical Periodicals were evaluated according to Cochrane collaboration's tool for assessing risk of bias and Jadad scale.Results A total of 53 RCTs were included,14 (26.4％,14/53) described radom number table used to generate the random allocation sequence,4 (7.5％,4/53) conducted experiments in a blinded manner,7 (13.2％,7/53) did not use intentionto-treat to analyse those who did not complete the study,9 (17.0％,9/53) had high risk of other bias,none described allocation concealment mechanism and blinding to participants and intercention implementers.Based on Jadad scales,the score was 1-4,average score was (2.3±0.8),19 (35.8％,19/53) were high-quality literatures.Conclusions The quality of present published literatures is not high,the further domestic studies should be designed high-quality to better improve clinical practice.

ObjectiveTo investigate the safety and efficacy of combined treatment with subtotal corpectomy and radiofrequency ablation(RFA) for spinal metastases. MethodsFrom April 2009 to March 2010, 29 patients with spinal metastases who received subtotal corpectomy were analyzed. Sixteen patients (7 men and 9 women) with an average of 57.8 years having received subtotal corpectomy alone were selected for comparison (the subtotal corpectomy group). Thirteen patients (7 men and 6 women) with an average of 58.3 years having received subtotal corpectomy combined with RFA were chosen as subjects of this study (the RFA combination group). There were no significant differences between the two groups with respect to the patient's age, gender, and Tomita type. Pain levels pre-and post-procedure were assessed by the visual analogue scale(VAS), and neurologic deficit were evaluated by the Frankel scale. ResultsThe VAS in RFA combination group were 8.88±0.36, 3.76±0.33, 3.35±0.38 in preoperation, 1 month, and 6 months postoperatively, respectively. The VAS in subtotal corpectomy group were 8.96±0.39, 3.81 ±0.48, 3.41 ±0.42 in preoperation, 1 month, and 6 months postoperatively, respectively. The VAS in both groups showed statistical significance at each time point, there was no statistically difference between the two groups. The operate time in RFA combination group and subtotal corpectomy group were(216.54±113.77) min and(302.50±80.44)min, respectively. The blood loss of the two groups were (1084.62±539.82)ml and (1625.00±724.34)ml, respectively. The recurrent rate of the two groups were 30.8％ and 75.0％, respectively. The RFA combination group were lower in operate time, blood loss and recurrent rates than subtotal corpectomy group. Conclusion Compared with the subtotal corpectomy, the RFA combination can reduce the blood loss, operation time, and the recurrent rates.

Objective To investigate the adiponectin levels in non-obese first-degree relatives (FDR)of type 2 diabetic subjects and its relation to insulin sensitivity and the intima-media thickness of the common carotid artery (IMT) during 5-year follow-up. Methods Fifty-three FDR subjects and 37 control subjects who were free of type 2 diabetes were enrolled. Plasma adipenectin, lipid profile, blood glucose, fasting insulin, and blood pressure were determined at baseline and after 5-year follow-up. IMT and endothelial-dependent vasodilation (EDVD) were measured by high-resolution B-mode ultrasound imaging. Homeostasis model assessment was used to evaluate insulin resistance (HOMA-IR)and β-cell function (HOMA-β). 29 FDR subjects and 20 control subjects completed the follow-up. Results Comparing with the control, plasma adiponectin levels in non-obese FDR subjects were lower at baseline [(10.06±5.79)vs (14.43±7.91) mg/L, P< 0.05]. Plasma adiponectin were decreased 24.0% in non-obese FDR and 36.7% in control duning 5 year follow-up (both P<0.05). Adiponectin levels were negatively correlated with waist-to-hip ratio (r = -0. 397), fasting blood glucose (r = -0. 373), IMT (r = -0. 372), and HOMA-IR (r=-0. 40)in the non-obese FDR. After adjusting other relevant risk factors,adiponectin was associated with age, high-density lipoprotein-cholesterol, and IMT in multiple regression analyses in non-obese FDR group. In the control group, a similar analysis revealed that low-density lipoprotein-cholesterol and IMT explained 25% of the variability in the adiponectin concentration. Conclusion Plasma adiponectin levels were decreased after 5 years in both non-obese FDR and control subjects. Decreased adiponectin level may be related to IMT increment.

In this experimental study, the RGD-containing peptide was used to modify the surface of biomimetic PLGA-(ASP-PEG) matrix, and bone marrow stromal cells (BMSCs) were seeded onto these modified surfaces for three weeks. The effects of modified surfaces of matrix on the adhesion, proliferation and differentiation of BMSCs were explored. BMSCs were harvested from whole bone marrow of Sprague-Dawley (SD) rats in vitro, then were seeded onto peptide surface-modified matrix (Experiment group, EG) and matrices without modification (Control group, CG) respectively for three weeks. The number of adhesive cells was counted by using precipitation method after 4 h and 12 h incubation; the cells cytoskeletons were stained with FITC-conjugated phalloidin after 24h incubation; the cell density was investigated after 1 d, 2 d and 3 d of incubation; ALP activity of BMSCs was measured after 7 d, 14 d and 21 d of incubation with osteogenic medium. The cells from bone marrow were BMSCs and their purity was beyond 90% using flow cytometry (FCM) analysis. Sulphur binding energy in EG was shown by XPS to be 164 eV. BMSCs adhered on peptide surface-modified matrix were observed with SEM. Cell adhesion efficiency and quality in EG was better than that in CG, and cell cytoskeleton was more robust in EG. ALP activity was higher in EG than in CG. Peptide surface-modified PLGA-(ASP-PEG) was noted to have good compatibility with BMSCs and to promote cell adhesion and differentiation.
Animals ; Biocompatible Materials ; chemistry ; Bone Marrow Cells ; cytology ; drug effects ; metabolism ; Cell Adhesion ; drug effects ; Cell Differentiation ; drug effects ; Lactic Acid ; chemistry ; Oligopeptides ; chemistry ; Osteoblasts ; cytology ; Peptides ; chemistry ; Polyglycolic Acid ; chemistry ; Rats ; Rats, Sprague-Dawley ; Stromal Cells ; cytology ; drug effects ; metabolism ; Surface Properties ; Tissue Engineering ; Tissue Scaffolds

Neural stem cells (NSCs) cultured in vitro were implanted within three-dimensional (3D) and self-assembly hydrogel from IKVAV-containing peptide. The cytocompatibility of hydrogel with NSCs was explored. Neural cells harvested from the cerebral cortex of neonatal mice were dissociated mechanically and cultivated in serum-free media, and were immunohistochemically examined for Nestin, NSE (neuron specific enolase) and GFAP (Glial fibrillary acidic protein); the self-assembly hydrogel from 1 wt% amphiphilic peptide was formed with the addition of DMEM/F12 and observed under transmission electron microscope (TEM); 1 x 10(5) /ml NSCs implanted within hydrogel (3D culture system) and seeded onto the surface of coverslips covered with polylysine (two-dimensional culture system, 2D culture system) respectively were incubated without serum at 37 degrees C in 5% CO2 and 95% air. Then the cells in 3D culture system and 2D one were double-labeled with DAPI/Brdu and observed under fluorescence microscope. The Nestin-positive cells were found, and they were able to differentiate into NSE-positive neuron- like cells and GFAP-positive glial-like cells, TEM showed that the hydrogel derived from 1 wt% peptide solution was composed of nanofiber network with the fiber diameters ranging from 3 to 6 nm and the fiber length warying from 100 nm to 1.5 microm, NSCs labeled with Brdu in 2D system were thinly scattered, and those in 3D system formed many neurospheres; the positive rate in 3D was much higher than that in 2D system (P < 0.001). The self-assembly hydrogel from the amphiphilic peptide containing IKVAV sequence had good cyto-compatibility and promoted the proliferation of NSCs.
Animals ; Animals, Newborn ; Cells, Cultured ; Cerebral Cortex ; cytology ; Hydrogels ; pharmacology ; Materials Testing ; Neural Stem Cells ; cytology ; Peptides ; chemistry ; Rats ; Rats, Sprague-Dawley ; Surface-Active Agents ; chemistry

Objective To investigate osteocyte density as a potential index of bone biomechanical property. Methods Forty 7-month-old female Sprague-Dawley rats were randomly group (EST) and sham operation group (SHAM). At 15 weeks postoperation, the compression test was performed on L5 vertebral body and micro-computed tomography (μ-CT) was used to estimate the three-dimensional bone mineral density (BMD) and three-dimensional microstructure parameters of L6 vertebral body. After fatigue damage testing, the L6 vertebral body was bulk-stained in 1% basic fuchsin and embedded in methylmethacrylate. Mounted bone slices were used to measure microcrack parameters and osteocyte density. Results At 15 weeks postoperation, osteocyte density (Ot. N/T. area) was significantly decreased in OVX group compared with SHAM group and EST group [(1268. 1 ±191.2)/mm2 vs. (1760. 8 ± 376.6)/mm2 and (1550. 9± 202.2)/mm2, F = 3.513,P<0. 05]. Maximum load (ML) was significantly decreased and the length of microcrack (Cr. Le) was significantly increased in OVX group compared with SHAM group, EST group and GEN group [(84. 4±16.9)N vs. (110.3±25.6),(103. 9±15. 8)and(110.1±4. 9)N; (58. 1±6.8) μm vs. (24.2±8. 1), (36. 5±9. 7)and(28.5±7. 5)μm, F=9. 561,3. 179, all P<0. 05]. Compared with SHAM group and EST group, bone trabecula connection density (Conn. D) was significantly decreased and trabecular separation (Tb. Sp) was significantly increased in OVX group [(47.4±7.4) m-3 vs. (71.8±16.0)and (74.0±12.7)m-3;(315.0±32.7)μm vs. (222. 5±21.7)and (273.3± 50.0)μm, F=7. 635,7. 007, all P<0. 05]. Bone mineral content (BMC) was lower in OVX group than that in SHAM group[(6.5±2. 2)g vs. (7. 9±1.2)g, P<0. 05]. When data in four groups were overall analyzed, Ot. N/T. Ar was positively correlated with ML, Conn. D and BMC (R2 = 0. 7874, 0. 1153, 0. 1309, all P<0. 05), but was negatively correlated with Cr. Le and Tb. Sp (R2 =0. 5738, 0. 3964, both P < 0.05). Conclusions Osteocyte plays a crucial role in maintaining bone biomechanical property and osteocyte density may be considered as a useful indicator for assessing bone biomechanical property.