Objective To construct a management program for upper limb lymphedema prevention in postopera-tive breast cancer patients and to evaluate its effectiveness.Methods The first draft of the upper limb lymphede-ma prevention and management protocol for postoperative breast cancer patients was constructed on the basis of ev-idence summaries and qualitative interviews,and 2 rounds of correspondence were conducted in December 2022.Using the convenience sampling method,patients undergoing surgery for malignant tumours in the breast surgery de-partment of a tertiary-level hospital in Zhengzhou City were selected as the study subjects,and 58 patients admitted from January to March 2023 were included in the experimental group according to the time of their first visit.57 patients admitted from July to December 2022 were included in the control group and were given routine care.The rates of lymphedema occurrence,upper limb function score and patients'adherence to lymphedema prevention be-haviours after 1,3,and 6 months of intervention were compared between the 2 groups.Results The valid ques-tionnaire recovery rates of the 2 rounds of expert correspondence were 92.59％and 100％,and the authority coeffi-cients of the experts were 0.940 and 0.950,and the Kendall's harmony coefficients were 0.228 and 0.254,respec-tively(P＜0.00 1).The coefficients of variation of the 2nd round of correspondence were 0.07～0.24.The final draft of the programme included 5 first-level entries,12 second-level entries,and 32 third-level entries.During the appli-cation of the programme,a total of 5 cases were dislodged,and 55 cases were finally included in each of the ex-perimental and control groups.The results of repeated measures ANOVA showed that there was an interaction ef-feet between the upper limb function scores and lymphedema prevention behavior compliance scores before inter-vention and at 1,3,and 6 months after discharge between the 2 groups(P＜0.05).Simple effects analysis showed that at 1,3,and 6 months after discharge,the upper limb function score and lymphedema prevention behavior com-pliance score of the experimental group were better than those of the control group,and the differences were sta-tistically significant(P＜0.05).At 6 months post-intervention,the difference in the occurrence of lymphedema was statistically significant when comparing the 2 groups(P=0.032).Adverse events such as subcutaneous bruising and falls did not occur in either group.Conclusion The upper limb lymphoedema prevention and management pro-gramme for postoperative breast cancer patients constructed in this study is scientific,feasible and safe,and can ef-fectively reduce the incidence of lymphoedema in patients and improve their quality of life.

Objective:To retrieve the evidence on rehabilitation functional exercise for total knee arthroplasty (TKA) patients both domestically and internationally, and summarize the best evidence to provide a basis for constructing a management plan of rehabilitation functional exercise for TKA patients.Methods:Using population, intervention, professional, outcome, setting and type of evidence (PIPOST) to construct evidence-based nursing issues, all evidence on rehabilitation functional exercise for TKA patients was searched through computers in the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia, British Medical Journal (BMJ) Best Practice, Embase, UpToDate, Web of Science, Cochrane Library, PubMed, American College of Sports Medicine, National Institute for Health and Clinical Excellence, China National Knowledge Infrastructure, WanFang Data and China Biomedical Literature Database. The Chinese and English search terms were "knee replacement/knee arthroplasty" and "functional training/exercise/strength training/early mobilization/recovery/ rehabilitation". The types of literature included guidelines, systematic reviews, summary of evidence, expert consensus, clinical decision-making, and randomized controlled trials (RCTs) . The search period was from the establishment of the database to January 10, 2023. Two researchers trained in evidence-based nursing independently completed the literature quality evaluation, and combined with professional judgment, extracted and summarized evidence for literature that met quality standards.Results:A total of 11 articles were included, including 4 guidelines, 4 systematic reviews, 2 RCTs, and 1 clinical decision-making. A total of 26 best evidence pieces were summarized from 5 aspects, namely multidisciplinary organizational management, pre-rehabilitation exercise, rehabilitation functional exercise plan, continuous function exercise, and exercise compliance.Conclusions:The best evidence summarized regarding rehabilitation functional exercise for TKA patients can provide a basis for medical and nursing staff to develop management plans. Medical and nursing staff need to consider clinical practice, patient's own condition, and willingness when applying evidence, and develop targeted rehabilitation functional exercise plans.

An ultimate goal of neuroscience is to decipher the principles underlying neuronal information processing at the molecular, cellular, circuit, and system levels. The advent of miniature fluorescence microscopy has furthered the quest by visualizing brain activities and structural dynamics in animals engaged in self-determined behaviors. In this brief review, we summarize recent advances in miniature fluorescence microscopy for neuroscience, focusing mostly on two mainstream solutions - miniature single-photon microscopy, and miniature two-photon microscopy. We discuss their technical advantages and limitations as well as unmet challenges for future improvement. Examples of preliminary applications are also presented to reflect on a new trend of brain imaging in experimental paradigms involving body movements, long and complex protocols, and even disease progression and aging.

Objective To analyse tratment strategies and to evaluate the relation between different therapies and survival rate of patients of with asynchronous liver metastases after pancreatic cancer surgery (PCLM).Methods From January 2006 to January 2012,48 patients with PCLM were included in this study,and their medical records were retrospectively analyzed.Results Among the 48 patients,27 cases of liver metastases were found within six months after surgery,and the survival rate for 1,3 and 5 years was 22.2％,3.7％ and 0％,respectively,with the median survival of 6 months,and 21 cases of liver metastases were found after six months,and the survival rate for 1,3 and 5 years was 85.7％,30.6％ and 9.2％,with the median survival of 15 months,and the difference between the two groups was statistically significant (P ＜ 0.01).After pancreatic cancer surgery and adjuvant gemcitabine chemotherapy,the probability of liver metastases was 33.3％ (8/24) within six months,the median disease-free survival time was 8 months and the disease-free survival rate for 1,3 and 5 years was 20.8％,4.3％ and 0％.For patients without adjuvant gemcitabine chemotherapy,the probability of liver metastases was 79.2％ (19/24),the median disease-free survival time was 3 months and the disease-free survival rate for 1,3 and 5 years was 4.2％,0％ and 0％,and the difference between the two groups was statistically significant (P ＜ 0.01).The overall survival for patients undergoing resection of liver metastases combined with gemcitabine treatment was better than the other groups (P ＜ 0.01).And the overall survival for patients undergoing transhepatic arterial embolization (TACE) combined with gemcitabine treatment was better than TACE group,gemcitabine group or the observation group (P ＜0.05).There were no difference in overall survival between TACE group,gemcitabine group and observation group.Conclusions Pancreatic cancer patients who develop liver metastasis within six months after surgery have poor prognosis,but postoperative chemotherapy can delay the development of liver metastasis.For patients with resectable lesion,resection of asynchronous liver metastasis is the treatment of choice,and TACE combined with gemcitabine has better efficacy than that of single treatment.

OBJECTIVETo analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.

METHODSOne hundred and twenty-four patients with non-metastatic, resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection. The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.

RESULTSForty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery (38.7%). The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups < 40, 40-60, and > 60 were 68.8%, 33.3% and 35.1%, respectively. The rate of liver metastasis in the body mass index (BMI) group < 20 kg/m2, 20-25 kg/m2, and > 25 kg/m2 were 21.6%, 44.1% and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥ 3 months and < 3 months were 59.4% and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3% and it was 43.7% in patients without preoperative fatty liver. The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4% and 49.0%, respectively. The rate of liver metastasis in patients with venous tumor thrombus was 68.8% and it was 34.3% in patients without venous tumor embolus. The rate of liver metastasis in patients with postoperative chemotherapy was 31.2% and it was 51.1% in patients without postoperative chemotherapy. All those differences had statistical significance (P < 0.05). Univariate analysis revealed that age, body mass index (BMI), time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis. Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.

CONCLUSIONSOur data suggest that patient's BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer. Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Adult ; Aged ; Body Mass Index ; Humans ; Liver Neoplasms ; secondary ; Lymph Node Excision ; Middle Aged ; Pancreatic Neoplasms ; pathology ; surgery ; Regression Analysis ; Risk Factors

Objective To analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.Methods One hundred and twenty-four patients with nonm-etastatic , resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection.The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.Results Forty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery ( 38.7%) .The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups <40, 40-60, and >60 were 68.8%, 33.3%and 35.1%, respectively.The rate of liver metastasis in the body mass index ( BMI) group <20 kg/m2 , 20-25 kg/m2 , and >25 kg/m2 were 21.6%, 44.1%and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥3 months and <3 months were 59.4%and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3%and it was 43.7%in patients without preoperative fatty liver.The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4%and 49.0%, respectively.The rate of liver metastasis in patients with venous tumor thrombus was 68.8%and it was 34.3%in patients without venous tumor embolus.The rate of liver metastasis in patients with postoperative chemotherapy was 31.2%and it was 51.1%in patients without postoperative chemotherapy.All those differences had statistical significance ( P<0.05) .Univariate analysis revealed that age, body mass index ( BMI) , time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis.Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.Conclusions Our data suggest that patient′s BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer.Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Objective To analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.Methods One hundred and twenty-four patients with nonm-etastatic , resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection.The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.Results Forty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery ( 38.7%) .The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups <40, 40-60, and >60 were 68.8%, 33.3%and 35.1%, respectively.The rate of liver metastasis in the body mass index ( BMI) group <20 kg/m2 , 20-25 kg/m2 , and >25 kg/m2 were 21.6%, 44.1%and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥3 months and <3 months were 59.4%and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3%and it was 43.7%in patients without preoperative fatty liver.The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4%and 49.0%, respectively.The rate of liver metastasis in patients with venous tumor thrombus was 68.8%and it was 34.3%in patients without venous tumor embolus.The rate of liver metastasis in patients with postoperative chemotherapy was 31.2%and it was 51.1%in patients without postoperative chemotherapy.All those differences had statistical significance ( P<0.05) .Univariate analysis revealed that age, body mass index ( BMI) , time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis.Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.Conclusions Our data suggest that patient′s BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer.Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Objective To study the effect and safety of intra-arterial thrombolysis combined with mechanical ad-juvant in the treatment of acute large artery occlusive infarction of anterior circulation and posterior circulation. Methods Fourty-tow patients were divided into anterior circulation group (24 cases) and posterior circulation group(18 cases). The recanalization rate, NIHSS score (National Institute of Health stroke scale), GCS score ( Glasgow coma score,GCS), BI ( Barthel Index) excellent rate, symptomatic intracranial hemorrhage rate and mortality was analyzed after intra-arterial thrombolysis combined with mechanical aids therapy. Results The anterior circulation group was mainly caused by car-diogenic embolism (15/24, 62.5%) and posterior circulation group was mainly caused by atherosclerosis thrombosis (5/18, 72.2%). The NIHSS score was significantly lower after treatment (8.3±4.9 vs. 8.1±5.7) than before treatment(15.1±5.3 vs. 16.8±7.8)(P=0.001 vs. P=0.001), the GCS score was significantly higher after treatment(13.9±4.4 vs. 12.8±4.2)than be-fore treatment(9.5 ± 3.8 vs. 9.6 ± 3.7)(P=0.001 vs. P=0.021). The symptomatic intracranial hemorrhage rate was signifi-cant higher in anterior circulation group (5/24, 20.8%) than in posterior circulation group (0,0%) (P<0.05). Compared with the anterior circulation group, the recanalization rate trended to increase in posterior circulation group (P=0.830).The symptomatic intracranial hemorrhage rate in anterior circulation group (5/24,20.8%) was significant higher than in pos-terior circulation group (0,0%) (P<0.05), the mortality was similar between these two groups. Conclusions Intra-arterial thrombolysis combined with mechanical adjuvant therapy can improve neurological deficit in acute large artery occlusive infarction and increase the recanalization rate,which is more suitable for the treatment of posterior circulation infarction.

Upon glucose elevation, pancreatic beta-cells secrete insulin in a Ca(2+)-dependent manner. In diabetic animal models, different aspects of the calcium signaling pathway in beta-cells are altered, but there is no consensus regarding their relative contributions to the development of beta-cell dysfunction. In this study, we compared the increase in cytosolic Ca(2+) ([Ca(2+)]i) via Ca(2+) influx, Ca(2+) mobilization from endoplasmic reticulum (ER) calcium stores, and the removal of Ca(2+) via multiple mechanisms in beta-cells from both diabetic db/db mice and non-diabetic C57BL/6J mice. We refined our previous quantitative model to describe the slow [Ca(2+)]i recovery after depolarization in beta-cells from db/db mice. According to the model, the activity levels of the two subtypes of the sarco-endoplasmic reticulum Ca(2+)-ATPase (SERCA) pump, SERCA2 and SERCA3, were severely down-regulated in diabetic cells to 65% and 0% of the levels in normal cells. This down-regulation may lead to a reduction in the Ca(2+) concentration in the ER, a compensatory up-regulation of the plasma membrane Na(+)/Ca(2+) exchanger (NCX) and a reduction in depolarization-evoked Ca(2+) influx. As a result, the patterns of glucose-stimulated calcium oscillations were significantly different in db/db diabetic beta-cells compared with normal cells. Overall, quantifying the changes in the calcium signaling pathway in db/db diabetic beta-cells will aid in the development of a disease model that could provide insight into the adaptive transformations of beta-cell function during diabetes development.
Animals ; Calcium ; metabolism ; Calcium Signaling ; drug effects ; Cell Membrane Permeability ; drug effects ; Cells, Cultured ; Down-Regulation ; drug effects ; Endoplasmic Reticulum ; metabolism ; Glucose ; pharmacology ; Insulin-Secreting Cells ; cytology ; drug effects ; metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Obese ; Potassium Chloride ; pharmacology ; Sarcoplasmic Reticulum Calcium-Transporting ATPases ; metabolism ; Sodium-Calcium Exchanger ; metabolism ; Thapsigargin ; pharmacology ; Up-Regulation ; drug effects