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OBJECTIVE To investigate the inhibitory effect and the possible mechanism of hydrogen sulfide （H2S） on the proliferation of cardiac fibroblasts. METHODS The heart of neonatal SD rats was collected， and cardiac fibroblasts were separated with differential centrifugation. Using sodium hydrosulfide as the donor of H2S， the effects of H2S on the proliferation of cardiac fibroblasts induced by angiotensin Ⅱ （Ang Ⅱ）， hydroxyproline content and the expression of sirtuin 3 （SIRT3） protein were detected. After SIRT3 knockdown with siRNA technology， the effects of H2S on the proliferation of cardiac fibroblasts induced by Ang Ⅱ， hydroxyproline content， the expressions of collagen Ⅰ （Col Ⅰ）， collagen Ⅲ （Col Ⅲ ） and optic atrophy protein 1 （OPA1） were detected. RESULTS H2S could inhibit the proliferation of Ang Ⅱ-induced cardiac fibroblasts， reduce the content of hydroxyproline and increase the expression of SIRT3 （P＜0.05）. After down-regulating the expression of SIRT3 with siRNA technology， the inhibition of H2S on the proliferation of Ang Ⅱ-induced cardiac fibroblasts and the reduction of hydroxyproline content were both inhibited， and the effect of H2S on reducing the expression of Col Ⅰ and Col Ⅲ and enhancing the expression of OPA1 was also significantly weakened. CONCLUSIONS H2S inhibits the proliferation of Ang Ⅱ -induced cardiac fibroblasts through increasing the expression of SIRT3.
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@#Objective To compare the in-hospital outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) for bicuspid aortic valve (BAV) patients and tricuspid aortic valve (TAV) patients. Methods Patients (including BAV and TAV patients) who underwent TA-TAVR with the J-ValveTM in West China Hospital from July 2014 to July 2020 were included consecutively. The clinical outcomes of the patients were analyzed. Results A total of 354 patients were included in the study, 75 in the BAV group and 279 in the TAV group. There were 229 males and 125 females with a mean age of 72.2±6.0 years. No death occurred during the procedure, and the overall technical success rate was 97.7%. The all-cause in-hospital mortality rate was 1.4%. Twenty (26.7%) patients with BAV and 46 (16.5%) patients with TAV had mild or higher perivalvular leaks immediately after the procedure. No patients with BAV required permanent pacemaker implantation postoperatively, while 13 (4.7%) TAV patients required permanent pacemaker implantation, with an overall pacemaker implantation rate of 3.7%. One (1.3%) BAV patient and 7 (2.5%) TAV patients developed acute kidney injury postoperatively. One (1.3%) BAV patient and 1 (0.4%) TAV patient developed peri-operative myocardial infarction. The average postoperative hospital stay was 7.6±3.6 d for BAV patients and 8.6±6.1 d for TAV patients. There was no statistical difference in primary or secondary in-hospital outcomes between BAV and TAV patients (P>0.05). Conclusion Compared to TAV patients, BAV patients have similar in-hospital outcomes, with a low incidence of adverse clinical outcomes, which provides preliminary evidence for its implementation in Chinese patients with a high proportion of BAV.
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Objective:To investigate the characteristic of social ability in children and adolescents with attention deficit hyperactivity disorder (ADHD) and its relationship with core symptoms, emotional and behavioral problems.Methods:Fifty-nine children with ADHD aged 6-13 for outpatient department from June 2019 to June 2021 were selected as the ADHD group, and 62 normal children matched in age and sex were recruited as the typical development group(TD group). The social responsiveness scale (SRS), SNAP-Ⅳ rating scale and strengths and difficulties questionnaire (SDQ) were used to evaluate the social ability, core symptoms and emotional and behavioral problems of the subjects.SPSS 26.0 was used for statistical analysis.Non parametric test was used to compare and analyze the differences in social ability, emotional and behavioral problems between the two groups.Spearman correlation analysis was used to analyze the relationship between social ability and core symptoms, emotional and behavioral problems of ADHD group.Generalized linear regression was used to analyze the impact of gender, age, IQ, core symptoms, emotional and behavioral problems of ADHD group on social ability.Results:In the ADHD group, the total score of SRS (65(42, 83)), social perception (10 (8, 13)), social cognition (13 (9, 19)), social communication (19 (11, 29)), and autism like behavior (9 (5, 14)) were significantly higher than those of TD group(38 (27.5, 59.5), 7 (4, 12.5), 8 (6, 15), 12 (6.5, 20), 4 (2, 11)) ( Z=-2.97, -2.75, -2.41, -3.01, -2.64, all P<0.05) .The total score of SDQ difficulty, influence factors, mood, hyperactivity, conduct and peer interaction were significantly higher than those of TD group ( Z=-5.80, -6.89, -2.82, -8.59, -2.52, -3.81, all P<0.05). The total score of SRS and the scores of each subscale in ADHD group were positively correlated with the total score of SNAP -Ⅳ and the scores of each subscale ( r=0.33-0.71, all P<0.05). The total score of SRS and the score of social communication scale were positively correlated with the total score of SDQ difficulty, influencing factors, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.65, all P<0.05). Social perception was positively correlated with the total score of difficulty, hyperactivity and the scores of peer interaction subscale ( r=0.56, 0.32, 0.45, all P<0.05). The scores of social cognition and autism like behavior subscale were positively correlated with the total scores of difficulty, influencing factors, emotion and peer interaction subscale ( r=0.27-0.55, all P<0.05). The scores of social motivation subscale were positively correlated with the total scores of difficulty, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.55, all P<0.05). The total score of SRS and the scores of each subscale were negatively correlated with the scores of prosocial behavior subscale ( r=-0.63--0.49, all P<0.05). The total score of SRS was positively affected by gender, age, opposites and disobedience, emotion, hyperactivity and peer interaction ( B=0.05-0.23, all P<0.05), and negatively affected by the prosocial behavior subscale ( B=-0.07, P<0.05). Conclusion:ADHD children often have obvious social ability defects, which are clearly related to core symptoms, emotional and behavioral problems.The risk factors are opposition and disobedience, emotions and peer relationships, and the protective factor is prosocial behaviors.
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OBJECTIVE To study the quality grade stand ard of the premature Forsythia suspensa . METHODS A total of 138 batches of premature F. suspensa were collected from the main producing areas of F. suspensa in China. According to 2020 edition of Chinese Pharmacopoeia ，the contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were determined ，and the qualified samples were screened. AHP-PCA mixed weighting method was used to give comprehensive weight to the indicators （except for the limit of impurity ）. The comprehensive score of the samples was calculated. The suggestions on the quality grade division of premature F. suspensa were put forward according to cluster analysis of K-mean value. RESULTS & CONCLUSIONS The contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were 0-7.80％，1.60％-8.18％，13.13％-61.60％，0.21％-3.47％，0.02％-2.15％ and 0.79％-14.04％，respectively；average contents of them were 1.24％，4.97％，34.88％，2.01％，0.42％，6.86％，respectively. Totally 47 batches of 138 batches were qualified in all indexes. It is suggested that the quality grade of the premature F. suspense can be divided into three grades ：in first grade of F. suspense ，the contents of volatile oil ，forsythin，forsythoside A ， ethanol-soluble extract and moisture were ≥2.40％，≥0.59％，≥8.34％，≥38.66％ and ≤4.99％，respectively；in second grade of F. suspense ，the contents of above indicators were ≥2.26％，≥0.41％，≥7.47％，≥32.58％ and ≤5.33％，respectively；in third grade of F. suspense ，the contents of above indicators were ≥2.15％，≥0.32％，≥4.60％，≥31.52％ and≤7.23％，respectively.
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@#Transcatheter aortic valve replacement (TAVR) for severe aortic stenosis is growing rapidly. The use of new heart valves prosthesis has improved surgical safety and efficacy. This report described a 72-year-old male patient with severe aortic stenosis combined with severe aortic regurgitation, who was evaluated at moderate-high risk of surgery and received a transapical TAVR using the Ken-Valve heart valve. The transcatheter operation time was 8 min, and the blood loss was 50 mL. The tracheal intubation was removed immediately after the surgery. Transesophageal echocardiography on the 4th postoperative day showed that the aortic valve leaflets worked well, and there was no valve orifice and paravalvular leakage. The patient was discharged on the 5th day after the surgery without complications. Transapical TAVR using Ken-Valve was an easy surgical procedure for aortic valve disease, and had short operation time.
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Objective:To investigate the value of radiomics based on unenhanced CT texture analysis in predicting the WHO/International Society of Urological Pathology (ISUP) grading of clear cell renal cell carcinoma (ccRCC).Methods:Postoperative pathology-confirmed ccRCC subjects ( n=90) who received CT scanning and had a definite pathological grading in Cancer Hospital of the University of Chinese Academy of Sciences were collected retrospectively from December 2016 to May 2019. The cases were randomly divided into training group ( n=63) and test group ( n=27) as a ratio of 7∶3. All cases were classified into low grade (grades Ⅰ and Ⅱ, n=57) and high grade (grades Ⅲ and Ⅳ, n=37) according to the new pathological grading (WHO/ISUP grading, version 2016) of renal carcinoma. 3D-ROI segmentation was performed on unenhanced CT images and 93 texture features were extracted. The least absolute shrinkage and selection operator (LASSO) regression was used to reduct dimension of texture parameters and then the radiomics score (Rad-score) was established. The logistic regression was used to develop the prediction model with the pathological grading as the gold standard. The ROC curve and calibration curve were used to evaluate the predictive performance of the model, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. The Hosmer-Lemeshow test was used to evaluate calibration degree of the model. Results:The 10 non-zero coefficient texture features were screened out through dimension reduction steps. The Rad-score was formed according to the linear combination of these ten features and corresponding coefficients, and then the prediction model was developed. The AUC of the model in training group was 0.933 (95%CI 0.862-1.000), the sensitivity was 92.3%, the specificity was 89.2%, and the model accuracy was 90.5%. The calibration curve showed the good calibration ( P=0.257). The AUC value in test group was 0.875 (95%CI 0.734-1.000), the sensitivity, specificity and accuracy were 72.7%, 87.5% and 81.5%. The calibration curve showed the good calibration ( P=0.125). Conclusion:The radiomics prediction model based on unenhanced CT texture analysis have application potential for the evaluation of WHO/ISUP grading of ccRCC.
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Objective@#To explore the influence of parental company before and after having second child on the emotional and behavioral problems of preschool firstborn children, and to provide a reference for emotional problems prevention of firstborn children.@*Methods@#Questionnaire survey was conducted among mothers of firstborn children who met the inclusion and exclusion criteria from two Grade A hospitals in Chongqing from March to December 2019. The average age of 845 firstborn children was (3.56±1.24) years old. The chi square test was used to compare the general characteristics and parent company of boys and girls. Rank sum test was used to compare the differences of emotional and behavioral problems of firstborn children with different parents company. Multiple linear regression models were used to compare the differences of internalizing, externalizing and total problems in firstborn children with different parents company.@*Results@#After having the second child, parents spent less time with their firstborn children, among which the decrease of the accompanying time of the mother and the total accompanying time of the parents were statistically significant( Z =3.76, 2.86, P <0.05). The scores of internalizing problem were higher when the mother s company time decreased ( B=1.18, 95%CI = 0.01 -2.36) and the parents total company time decreased( B=1.41, 95%CI =0.33-2.48). The scores of the externalizing problem ( B=1.25, 95%CI =0.10-2.39) and the total problem ( B=4.31, 95%CI =1.05-7.57) with the decrease of parents total company time were higher.@*Conclusion@#Parent company has an important influence on the emotional and behavioral problems of firstborn children. Firstborn children whose parents accompanying time decreases after having second children scored higher on emotional and behavioral problems.
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RNF20, an E3 ligase critical for monoubiquitination of histone H2B at lysine 120 (H2Bub), has been implicated in the regulation of various cellar processes; however, its physiological roles in adipocytes remain poorly characterized. Here, we report that the adipocyte-specific knockout of Rnf20 (ASKO) in mice led to progressive fat loss, organomegaly and hyperinsulinemia. Despite signs of hyperinsulinemia, normal insulin sensitivity and improved glucose tolerance were observed in the young and aged CD-fed ASKO mice. In addition, high-fat diet-fed ASKO mice developed severe liver steatosis. Moreover, we observed that the ASKO mice were extremely sensitive to a cold environment due to decreased expression levels of brown adipose tissue (BAT) selective genes, including uncoupling protein 1 (Ucp1), and impaired mitochondrial functions. Significantly decreased levels of peroxisome proliferator-activated receptor gamma (Pparγ) were observed in the gonadal white adipose tissues (gWAT) from the ASKO mice, suggesting that Rnf20 regulates adipogenesis, at least in part, through Pparγ. Rosiglitazone-treated ASKO mice exhibited increased fat mass compared to that of the non-treated ASKO mice. Collectively, our results illustrate the critical role of RNF20 in control of white and brown adipose tissue development and physiological function.
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ObjectiveTo investigate the molecular mechanism of the anti-liver fibrosis effect of curcumol by observing the effect of curcumol on the TLR4/NF-κB signaling pathway in liver sinusoidal endothelial cells. MethodsA total of 50 mice were randomly divided into blank group, model group, and curcumol group, and cells were divided into blank control group, LPS positive control group, curcumol intervention group, and PDTC group. HE staining and Masson staining were used to observe the change in liver structure; Western blot and quantitative real-time PCR (RT-PCR) were used to measure the protein and mRNA expression of the key molecules TLR4 and NF-κB in the TLR4/NF-κB signaling pathway; immunofluorescence assay was used to observe the expression and nuclear import of NF-κB in cells. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsRT-PCR showed that compared with the positive control group, the curcumol intervention group had significant reductions in the mRNA expression of TLR4 and NF-κB (both P＜0.05). Western blot showed that compared with the positive control group, the curcumol intervention group had significant reductions in the expression of TLR4 and NF-κB (both P＜005). Immunofluorescence assay showed that compared with the positive control group, the curcumol intervention group had significant improvement in NF-κB nuclear import. ConclusionCurcumol can exert an anti-liver fibrosis effect possibly by inhibiting the activity of the TLR4/NF-κB signaling pathway.
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Objective@#To explore the association between different family factors and children’s puberty timing, and to provide a reference for further research on puberty development of children.@*Methods@#A prospective cohort study was conducted on a total of 1 237 children in one district, Chongqing, using targeted sampling. Cox regression was used to analyze the association between family factors and the puberty timing of children.@*Results@#The results of univariate analysis showed that baseline age and BMI were risk factors of early puberty timing in boys and girls (P<0.01). Breast development (HR=1.27, 95%CI=1.04-1.54) was observed earlier in vaginal delivery than in cesarean section. Self-conscious family economic condition is good is the protective factor for the early timing of girl’s menstruation (HR=0.81, 95%CI=0.66-0.99), pubic hair development(HR=0.80, 95%CI=0.65-0.97) and the boy’s puberty development (Testicular development HR=0.69, 95%CI=0.58-0.83, first ejaculation HR=0.62, 95%CI=0.49-0.78, external genitalia development HR=0.70, 95%CI=0.56-0.87, pubic hair development HR=0.66, 95%CI=0.54-0.80). The left-behind boys later observed testicular development (HR=0.74, 95%CI=0.57-0.96), first ejaculation (HR=0.71, 95%CI=0.50-0.99) and pubic hair development (HR=0.68, 95%CI=0.51-0.91). Testicular development (HR=1.26, 95%CI=1.01-1.58) was observed earlier in boys who felt their parents were close (P<0.05). The results of multivariate analysis showed that the timing of pubic hair development was later in floating girls (HR=0.79, 95%CI=0.65-0.96), and family factors had nothing to do with the puberty timing in boys.@*Conclusion@#In the study, left behind children, self-perceived of parents relationship and family economic conditions are the influencing factors of children’s puberty timing. However, after adjusted for age and BMI, this association was mainly found in pubic hair of girls. The association between family factors and other pubertal development events still needs to be confirmed by further follow-up investigation.
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Biofilms are microbial communities composed of bacteria cells and self-produced extracellular polymeric substances and lead to antibiotic resistance, forming a great threat in the fields of medicine, food industries and so on. The formation of biofilms is a multi-stage dynamic process regulated by multiple mechanisms. Recently, researchers paid much more attention to the related research areas of biofilms, especially the detection methods of biofilms. This paper introduced the characteristics and formation process of biofilms as well as the effects of quorum sensing on biofilms development. Meanwhile, we discussed the detection methods of biofilms, especially electrochemical impedance spectroscopy (EIS) in detection of biofilms in detail. Furthermore, we reviewed and predicted that microfluidic chips based EIS served as an in-situ and online monitoring method for biofilms growth.
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Objective To explore the value of CT radiomics model in predicting three-year survival time in patients with primary hepatocellular carcinoma (HCC). Methods Eighty one patients pathologically or clinically confirmed HCC and B stageof Barcelona clinical liver cancer before transcatheter arterial chemoembolization (TACE) in Zhejiang Cancer Hospitalwere retrospectively enrolled from January 2010 to June 2014.A primary cohort consisted of 64 patients and an independent validation cohort consisted of 17 patients. The patients were divided into survival group of 39 cases and death groupof 42 cases duringthree-year follow-up. All the patients underwentnon-enhanced and contrast-enhanced CTimages scan before TACE. Three hundered and seventy six quantization radiomics features were extracted from the arterial phase and portal phase CTimages of target lesion. LASSO regression model was used for data dimension reduction. Logistic regression was used to develop the prediction model. The predictive ability of the model was validated using the area under the curve (AUC) of receiver operating characteristic(ROC) analysis. Results The radiomics features selected from the arterial and portal phase were 8 and 5, respectively. The arterial prediction model showed AUC=0.833, sensitivity=83.9％(26/31), specificity=81.8％(27/33), accuracy=82.8％(53/64)in primary datasetand AUC=0.861, sensitivity=75.0％(6/8), specificity=100.0％(9/9), accuracy=88.2％(15/17)in independent validation dataset.The portal prediction model showed AUC=0.858, sensitivity=83.3％(25/30), specificity=85.3％(29/34), accuracy=84.4％(54/64)in primary dataset and AUC=0.750, sensitivity=75.0％(6/8), specificity=100.0％(9/9), accuracy=88.2(15/17)in independent validation dataset. Conclusion This study shows CT radiomics model can be conveniently used to facilitate the preoperative individualized prediction of three-year survival time in patients with HCC.
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In recent years, the incidence of hepatocellular carcinoma (HCC) has risen year by year, leading to a high mortality rate. At present, surgical treatment is the major cure for HCC, and in general, HCC is diagnosed at late stages. Due to the heterogeneity of HCC and different sensitivities to drugs, the treatment efficacy of advanced HCC is poor. In this paper, we retrospectively analyzed the prog-ress of HCC treatments and reviewed important progression, which provides new view for the clinical improvement of the total surviv-al of patients with HCC.
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Transcatheter arterial chemoembolization (TACE) has already been a mature and an effective treatment for advanced hepatocellular carcinoma (HCC).Clinically,it is very important to quickly and accurately evaluate the postoperative curative effect with minimally invasive technique so as to determine the next treatment options.At present,postoperative conventional CT and MRI are the main means to assess the curative effect of TACE,but it is a pity that after the treatment the functional changes of the tumor occur earlier than the morphological changes.In recent years,functional MRI techniques,such as diffusionweighted imaging (DWI),multi-b value DWI,dynamic contrast-enhanced (DCE) imaging,etc.have been more and more used for quantitative evaluation of the diffusion of water molecules and the blood microcirculation perfusion within the tumor tissue,and some progresses have been achieved in the evaluation of curative efficacy for tumor.This paper aims to make a comprehensive review about the research progress of the above mentioned functional imaging methods as well as their current application status in evaluation of the curative effect of TACE.
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Objective@#To analyze the quantitative expression and prognostic significance of tumor neo-vessels, macrophages and fibroblasts in tumor microenvironment of hepatocellular carcinoma (HCC).@*Methods@#The clinic-pathological features and tissue samples for 101 HCC cases were collected. Immunohistochemistry was used to stain the tumor neo-vessels, macrophages and fibroblasts on tumor tissue. The distribution results and quantitative data of above key components were acquired by inverted microscopy equipped with CRi Nuance multispectral analysis system. The number of tumor neo-vessels and macrophages on HCC tissue were counted and the thickness of cancer stroma based on the expression of fibroblasts was measured. The clinic-pathological characteristics and overall survival were analyzed.@*Results@#The median disease free survival (DFS) of 101 HCC cases was 5 month. The quantitative analysis of tumor neo-vessels, macrophages and fibroblasts showed that the expression range was 51-429 with median 218, 110-555 with median 259, 35.61-555.35 with median 246.98, respectively. To take the median as cutoff, all the cases could be classified into high and low expression group. The survival analysis demonstrated that the high density group of macrophages (P=0.022) and fibroblasts (P<0.001) has shorter DFS than low density group, with statistical significance. The high tumor neo-vessels group has shorter DFS with median 5 month than low density group with median 7 month. However, there was no statistical significance between these two group (P=0.197). Combined with above the three stromal components, all the cases could be classified into low, middle and high group. The survival analysis demonstrated that the high density group of stromal components has shorter DFS than the other two groups with median 3 month (P=0.001). Multivariate analysis by Cox regression indicated that cirrhosis, metastasis status, macrophages and fibroblasts density were the independent prognostic factors.@*Conclusion@#The key elements in tumor microenvironment including tumor neo-vessels, macrophages and fibroblasts were heterogenic in HCC tissues and played significant roles in HCC invasion and metastasis.
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Objective To discuss the application of routine CT three-phase perfusion parameter,that is arterial enhancement fraction (AEF) value,in evaluating the curative effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods The clinical data of a total of 30 patients with pathologically proved HCC were enrolled in this study.Routine CT three-phase perfusion scan was performed 1-3 days before as well as 30-40 days after TACE in all patients.AEF value was calculated by using CT Kinetics software (GE Healthcare).The formula for calculating AEF value was as follows:AEF value=(arterial phase CT value-plain scan CT value)÷(portal phase CT value-plain scan CT value).The results were statistically analyzed.Results Effective treatment group had 17 patients,and ineffective treatment group had 13 patients.The postoperative AEF values in the effective treatment group and the ineffective treatment group were (0.351±0.090) and (0.438±0.050) respectively,the difference between the two groups was statistically significant (P＜0.05).Taking postoperative AEF value of 0.392 as the critical value to predict the postoperative effect of TACE,the sensitivity and specificity were 86.7％ and 73.2％ respectively,and the area under the curve was 0.876 (P＜0.001).Conclusion The routine CT three-phase perfusion parameter (AEF) can quantitatively reflect the hemodynamic changes of HCC after TACE,which is helpful for making early evaluation of TACE effect,meanwhile,no additional radiation dose will be added.
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Objective To explore a new approach to isolate the umbilical cord-mesenchymal stem cells (UC-MSCs) from a whole umbilical cord. Methods Single enzyme was used to digest the whole umbilical cord,and passaged and cultured,draw the growth curve,cell cycle and cell wall antigen on the surface by flow cytometry. In particular inducing system, the adherent cells were induced into adipocytes and osteoblast. Results The mesenchymal stem cells (MSCs) were derived from the whole umbilical cord. The growth curve showed that the cell doubling time was (24.15 ± 0.49) h and the percentage of G1phase cells was 82.66%.The adherent cells expressed the CD93,CD105,CD44,CD29and CD73, and did not express the CD34, CD45, CD31and human leukocyte antigen DR (HLA-DR). UC-MSCs could differentiate into adipocytes and osteoblast. Conclusions Single enzyme approach is a good method to obtain UC-MSCs from whole human umbilical cord,and it provides a theoretical basis for the establishment of MSCs bank and clinical application.
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Objective To discuss the perioperative nursing based on a recent patient with acute Stanford type A aortic dissection undergoing hybrid operation including David, debranch and thoracic endovascular aortic repair procedures. Methods The specialised perioperative nursing tactis were recommended including routine practice, pain control, psychological guidance, vital signs management, respiratory care, anti-coagulation therapy and other related treatments. Results As the active treatment and nursing, this patient recovered successfully and discharged smoothly with no sign of any complications. Conclusions Even though the condition of Stanford type A aortic dissection patients is unstable, complicated and dangerous, the promotion of their life quality could be still accessible by well organized combine of both doctors′ and nurses′ endeavor: David, debranch and thoracic endovascular aortic repair procedures.
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Objective To discuss the perioperative nursing based on a recent patient with acute Stanford type A aortic dissection undergoing hybrid operation including David, debranch and thoracic endovascular aortic repair procedures. Methods The specialised perioperative nursing tactis were recommended including routine practice, pain control, psychological guidance, vital signs management, respiratory care, anti-coagulation therapy and other related treatments. Results As the active treatment and nursing, this patient recovered successfully and discharged smoothly with no sign of any complications. Conclusions Even though the condition of Stanford type A aortic dissection patients is unstable, complicated and dangerous, the promotion of their life quality could be still accessible by well organized combine of both doctors′ and nurses′ endeavor: David, debranch and thoracic endovascular aortic repair procedures.
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Along with the aging process, the spectrum of liver disease changes greatly. Nonalcoholic fatty liver disease (NAFLD) in elderly people lead to low liver function and is also the major cause of extrahepatic diseases, such as cardiovascular disease and malignant tumor. This review provides an overview of the morphological structure and function of the liver in aged people, and discusses the characteristics of weakness, malnutrition and limited movement in the elderly, as well as the current status of multiple diseases and multiple drug use. Finally, this article puts forward some appropriate regimens for the diagnosis and treatment of NAFLD in elderly people to provide a reference for clinical practice.