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With the intensive aging of the population, it's imperative and important to train a number of geriatric specialists. Essential clinical knowledge and skills as well as accomplishment of medical humanistic spirit are core competences of an eligible geriatrician. The standardized training of geriatric specialists is facing a few challenges such as incomplete comprehension of the training program and trainees, a lack of enough trainees, and a lack of standardized management for the program. An efficient social support system, a normative educational training system, an effective supervision and evaluation system, first-class teaching staff, and qualified trainees are important guarantees for the standardized training program.
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Objective:To investigate the application value of right minimal invasive three-port technique of laparoscopic sleeve gastrectomy (RMIT-LSG) for the treatment of obesity.Methods:The retrospective and descriptive study was conducted. The clinical data of 66 obesity patients who underwent RMIT-LSG in the Sir Run Run Shaw Hospital of Zhejiang University School of Medicine from January to October 2021 were collected. There were 15 males and 51 females, aged 28.5(range, 16.0?54.0)years. The body mass index (BMI) of the 66 patients was (36.9±4.3)kg/m 2. There were 20 of the 66 patients combined with type 2 diabetes. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination or the WeChat to detect postoperative recovery of patients including body mass changing, BMI and complications 6 months after operation. The follow-up was up to December 2021. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 66 patients underwent RMIT-LSG successfully, without conversion to laparotomy or changing surgical method. The operation time and the volume of intraoperative blood loss of the 66 patients were (132±22)minutes and (14±8)mL, respectively. (2) Postoperative situations. The time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial water intake, time to postoperative initial liquid food intake and duration of postoperative hospital stay of the 66 patients were (15±6)hours, (1.80±0.60)days, (1.00±0.20)days, (2.00±0.20)days and (3.40±0.60)days, respectively. Of the 66 patients, one case underwent post-operative abdominal hemorrhage at postoperative day 1 and received a second surgery for hemostasis. The patient with postoperative abdominal hemorrhage and other 65 patients recovered well without gastroparesis, gastric fistula, abdominal infection and other complication. (3) Follow-up. All the 66 patients were followed up for 6(range, 1?11)months. All the 66 patients completed the postoperative scar photography at postoperative 1 month, and results of scar photography showed concealed scar with good cosmetic effects. Twenty-seven of the 66 patients were followed up for 6 months after operation, with the weight loss, percentage of weight loss and decrease of BMI were (42±7)kg, 34.8%±2.9%, (14.2±1.9)kg/m 2, respectively. None of the 66 patient had innutrition during the follow-up. Conclusion:The RMIT-LSG is safe and feasible for the treatment of obesity, with a good cosmetic effect of the wound.
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Objective To explore the gait features under dual task walking and its relationship of fear of falling in elderly patients with type 2 diabetes.Methods A total of 168 elderly patients with type 2 diabetes were selected.Patients were asked to complete the general information questionnaire,mini-mental state examination and fear of falling assessment.The gait parameters under normal and dual task walking were measured objectively and quantitatively by IDEEA,and the relationship between fear of falling and the gait parameters under dual task walking were explored.Results Elderly patients with type 2 diabetes were more prone to gait abnormalities in dual task walking,and compared with those who are not fear of falling,the gait performance in dual task walking decreased significantly in the patients with fear of falling,such as lower velocity and step length,higher variability of stride time(all P＜0.05).Conclusion Elderly patients with type 2 diabetes were more prone to gait disorders in dual tasking than normal walking.Normal walking test may overestimate the actual walking ability of patients.In contrast,dual task walking test can better reflect the challenges of daily life,and be closer to the patient walking patterns in real life,which might be better suited for assessing actual mobility of patients.In addition,elderly patients with type 2 diabetes who are fear of falling are more prone to gait abnormalities in dual tasking walking.
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The aim is to explore and build the treatment-care and four linkage combination integrated care model,so as to provide methods and ideas for the medical service practice.By exploring the mechanism and hierarchical management mode of the treatment-care and four linkage combination integrated care model,we have set up a whole process management closed loop in four combined linkage,including hospital,medical care,community and family,raised to solve the medical combination of acute medical treatment and the problems existing in the continuing care.After more than a year of preparation and practice,we have build the social service centered medical combined with four linkage information platform,and have realized the online and offline medical combination of care services in hospital,medical care,community and family.Based on Intemet technology,the building of the treatment-care and four linkage combination integrated care model is the efficient method to solve the difficulties and problems of the health care and the continuation demands among elderly under the current conditions,and the feasible way to realize theslight illness in the community,disease the hospital,care in institutions,pension in the family.
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Objective To explore gait features at usual speed of community-dwelling elderly people,and its relationship with history of falls in the past one year.Methods According to history of falls in the past one year,135elderly people in Hefei City were recruited and divided into fallers(23 cases) and non-fallers(112 cases).Self-designed questionnaires were completed by all participants to collect data including gender,age,frequency of exercise,BMI,Barthel Index,MMSE,fear of fall and so on.Gait parameters were measured by IDEEA LifeGait when participants walked for 10 meters at usual speed.Results Between fallers with non-fallers,the time of Timed Up and Go Test had statistically significant differences(P＜0.05).Gait analysis results showed that swing power,foot fall,preswing angle,speed had statistically significant differences between two groups (all P＜0.05).Conclusion When community-dwelling elderly people are walking at usual speed,the shorter of the time of Timed Up and Go Test,the weaker of swing power,foot fall and pre-swing angle and the slower speed is,the more possible falls will occur.
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BACKGROUND:Neural stem cells, as a hot topic in neuroscience research, have a wide application prospect in the treatment of neurological damage, but how to obtain a large number of terminally differentiated and purified nerve cells with homogeneous features is a difficult problem in this field. The use of intracellular fluorescence reporter system to track the process of neural stem cell differentiation and obtain a single kind of terminally differentiated and purified nerve cells provides a viable option. OBJECTIVE: To explore the value of GFAP promoter-driven fluorescence reporter system in tracing the neural differentiation of neural stem cells (NSCs). METHODS: Cerebral cortex of mouse embryos were primarily dissociated and sent for digesting and pipetting mechanically before suspension culture, followed by immunofluorescence staining of Nestin to identify their biological characteristics. Lentivirus carrying pLV/Final-neo-GFAP(promoter)-dTomato vector was employed to infect above-mentioned NSCs, and Geneticin (G418) was used to obtain purified NSCs at 14 days. Subsequently the purified cells were induced to differentiate into astrocyte-like cells; meanwhile red fluorescence changes in cells were observed by microscopy. The red fluorescent cells were then subjected to perform immunofluorescence staining at 13 days after induction. RESULTS AND CONCLUSION:The expression of Nestin in the isolated primary cells was strongly positive. Purified NSCs were obtained by lentivirus infection and subsequent G418 resistance selection at 14 days. After induced into astrocyte-like cells, the red fluorescence was observed in the cells under the microscope and furthermore, GFAP staining was also positive. Mouse NSCs carrying neo-GFAP(promoter)-dTomato were successfully obtained. The cells could express dTomato under the control of GFAP promoter, which provides a powerful tool for research on NSC differentiation mechanism, neural transplantation and tissue engineering product development.
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Objective@#To investigate the clinical effect and safety of entecavir capsules in the treatment of treatment-naïve HBeAg-positive patients with chronic hepatitis B (CHB).@*Methods@#A total of 158 HBeAg-positive CHB patients were given oral entecavir capsules at a dose of 0.5 mg/time once a day for 144 weeks. Clinical outcome and safety were evaluated at baseline and at 24, 48, 72, 96, 120, and 144 weeks of treatment respectively. The Fisher’s exact test was used for the analysis of categorical data.@*Results@#After 144 weeks of treatment, 90.91% of all patients achieved virologic response (< 69 IU/ml), the normalization rate of alanine aminotransferase was 88.18%, the clearance rate of HBeAg was 33.33%, and the seroconversion rate of HBeAg was 24.07%. Of all patients, 2 dropped out due to adverse events and 5 experienced serious adverse reactions.@*Conclusion@#Entecavir capsules can inhibit viral replication and have good safety in treatment-naïve HBeAg-positive CHB patients.
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Objective To measure the nursing time that the geriatric patients need daily in a large general hospital in Anhui province,thus to understand the direct and indirect nursing items and time.Methods Timing and recording nursing operations to meet the conditions of the geriatric patients for 7 consecutive days by field recording method were done.Results The average time of each nursing procedures was calculated.Direct nursing time was 146.10 min,accounting for 84.70％ of the total nursing time,including primary care (42.81％) and respiratory/drain management proportion (15.86％); Indirect nursing time was 26.39 min,accounting for 15.30％ of the total nursing time.The actual number of nurse needed was 158,the suitable bed protection ratio was 1 ∶ 0.68.Conclusions Direct nursing time of geriatric patients needed was longer than that of indirect nursing time.To increase direct nursing hours and reduce the indirect nursing time can satisfy the need of elderly patients.In addition,the current nursing staffing cannot satisfy the clinical needs of the elderly,thus,nursing resources allocation should be reasonable arranged as soon as possible.
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It is extremely necessary and important for colleges or universities to transform the education concepts that barricade students' initiative and creativity, especially the one that takes fi-nal examinations as sole standard to evaluate teaching and learning effects. In order to display and cultivate students' study ability more comprehensively, we manage to establish a set of formative eval-uation system for regional anatomy course , which involves tests and examinations and evaluations throughout the whole teaching and learning process. It solves the long-lasting problem that examina-tions are final purposes of teaching and learning, and thus, teaching values not only results but also learning process, which directs students' attention to conventional studies and helps develop good study habits, greatly reducing the randomness of final academic performances. The diverse assessment methods, along with accumulated assessment results, can improve students' learning effects through-out the whole semester. The fundamental purpose of this system is to inspire students' passion for study and creativity and monitor the teaching process.
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<p><b>OBJECTIVE</b>To study the effect of lentivirus-mediated RNA interference (RNAi) of nestin on the metastatic potential of human melanoma cell line UACC903.</p><p><b>METHODS</b>A lentiviral vector for RNAi targeting the coding region of human nestin mRNA (nestin-RNAi-LV) and another control vector containing a nonsense sequence were constructed. The vectors were transfected into UACC903 cells, and nestin expression in the cells was detected by RT-PCR, immunofluorence assay and Western blotting. The invasive ability and migration of the transfected UACC903 cells was evaluated using Transwell and scrape assay, respectively. Fluorescence assay was used to examine the expressions of E-cadherin, N-cadherin and β-catenin in the cells.</p><p><b>RESULTS</b>The lentiviral vector nestin-RNAi-LV was constructed successfully. Compared with the control vector, nestin-RNAi-LV resulted in obviously reduced expression of nestin mRNA and protein, lowered migration ability of UACC903 cells, and reduced cell adhesion and invasiveness (P<0.05).</p><p><b>CONCLUSION</b>Lentivirus-mediated nestin RNAi can specifically inhibit nestin expression to cause decreased cell migration and invasiveness of human melanoma cell line UACC903.</p>
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Humans , Cell Line, Tumor , Cell Movement , Genetics , Genetic Vectors , Intermediate Filament Proteins , Genetics , Metabolism , Lentivirus , Genetics , Melanoma , Pathology , Neoplasm Metastasis , Genetics , Nerve Tissue Proteins , Genetics , Metabolism , Nestin , RNA Interference , RNA, Messenger , Genetics , Metabolism , RNA, Small Interfering , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of mouse melanoma cell line B16F10-derived conditioned medium on the apoptosis of B16F10 cells.</p><p><b>METHODS</b>B16F10 cells were cultured in high-glucose DMEM in the presence of 10% fetal bovine serum, and upon cell confluence, the growth medium was replaced with serum-free high-glucose DMEM. After 8 h, the medium was collected and infiltrated to serve as the conditioned medium. B16F10 cells cultured in normal growth medium or the conditioned medium were exposed to 10 mmol/L sodium L-ascorbate, and the cell apoptosis was analyzed. The ingredients in the conditioned medium with relative molecular mass less or more than 5 000 were extracted to assess their effect on sodium L-ascorbate-induced cell apoptosis.</p><p><b>RESULTS</b>The conditioned medium for B16F10 cells significantly inhibited cell apoptosis induced by sodium L-ascorbate, and the effective ingredients in the medium showed a relative molecular mass below 5,000.</p><p><b>CONCLUSION</b>Mouse melanoma cell line B16F10-derived conditioned medium can suppress sodium L-ascorbate- induced apoptosis of B16F10 cells, and the ingredients with relative molecular mass less than 5 000 are responsible for this effect.</p>
Subject(s)
Animals , Mice , Apoptosis , Ascorbic Acid , Cell Line, Tumor , Culture Media, Conditioned , Pharmacology , Melanoma, Experimental , PathologyABSTRACT
Objective To explore an effective perioperative nursing management mode for elderly patients without caregivers. Methods The perioperative nursing management mode was implemented for 151 elderly patients without caregivers from 9 surgery departments. The work mode included admission safety assessment,nursing care classification,design of clinical nursing pathway,establishment of nursing group and quality control. Results The new work mode provided elderly patients with high-quality nursing care,ensured patient safety,increased patient and relatives satisfaction. Conclusion The perioperative nursing management mode is an effective way to ensure patient safety and promote patient comfort during perioperative period for elderly patients without caregivers.
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Objective To investigate clinical value of endoscopic ultrasonography (EUS) on diagnosis and treatment of esophageal leiomyoma.Methods The clinical feature of patients diagnosed as esophageal leiomyoma by EUS was analyzed.All patients underwent conventional gastroscopy and EUS examination as well as blood test.The EUS findings were compared with histopatholoical diagnosis for endoscopically or surgically resected specimens.All patients were followed-up with EUS for 14.3 months (range 2-36 months) for leiomyoma recurrence.Results A total of 191 patients were diagnosed with esophageal leiomyomas by EUS.Clinical manifestation,serum examination,conventional gastroscopy and spiral CT were not helpful for diagnosing esophageal leiomyoma,One hundred and sixteen patients with esophageal leiomyomas were treated by either endoscopic resection (111 cases) or surgical excision (5 cases).of which,101 resected specimens were pathologically confirmed as leiomyomas.The diagnostic accuracy of EUS was 87%.The follow-up study showed that there was no change of leiomyomas in 75 untreated patients and no recurrence was found in 116 surgically treated patients.Conclusion Esophageal leiomyoma is a benign tumor,EUS plays a very important role in diagnosis and treatment of this disease.
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Objective To summarize the clinical features of the duodenal lipomas in order to explore effective diagnostic methods and appropriate treatment preoperatively. Methods The clinical features, laboratory results, endoscopic appearance, radiological and pathological data of 8 cases of duodenal lipoma were retrospectively analyzed. Results Four patients suffered with repeated melena, 3 cases with epigastric discomfort, sour regurgitation or hiccup, while 1 patient without any symptoms. Liver functions, serum lipids and tumor markers were normal in all patients. Six patients had been detected lesions by gastroscopy (2 cases missed diagnosed in the first examination) , these lesions were appeared in duodenal bulb (2 cases) or descendant duodenum (4 cases). Abdominal CT examination revealed partial duodenal wall thickening (6 cases) , partial enteric cavity narrowing (4 cases) , or low-density lesions in enteric cavity (3 cases) with CT value of -85 HU and evenly intensified when enhanced. EUS showed intensive hyperechoic lesions from submucosa, with homogeneous echo and clear margin. Biopsy under endoscopy in all patients showed chronic inflammation of mucosa, while the pathologic diagnosis was lipoma after surgical excision or endoscopic resection. Pancreaticoduodenectomy performed in 1 patient, duodenal tumorectomy in 3 patients and endoscopic resection with snare in 4 patients. Conclusion Common site of duodenal lipoma is descending part, and the clinical manifestations are non-specific. Imaging and endoscopic examination are the mainly methods to detect the lesion, while EUS is significantly valuable in diagnosing and differential diagnosing. It can be treated by partial tumorectomy or endoscopic trap resection.
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Objective To investigate the diagnostic value of endoscopic ultrasonography (EUS) for duodenal cysts.Methods Clinical manifestations, results of conventional gastroscopy and EUS, as well as follow-up, of patients with duodenal cysts were retrospectively analyzed.Results A total of 105 patients with duodenal cysts presented with no lesion-related symptoms, but displayed characteristic imaging changes under EUS, which could reveal the origin, size and nature of duodenal cysts, and differentiate it from other submucosal lesions.A maximum follow-up of 5 years showed no changes in duodenal cysts.Conclusion Duodenal cyst is a benign disease, and EUS plays a very important role in diagnosis of the disease.
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[Objective] To establish an effective and stable method to induce hematopoietic cells from embryonic stem(ES) cells,the phenotype and function of ES-derived hematopoietic cells induced by stromal cell conditioned medium (SCCM) of yolk sac (YS),fetal liver (FL) or bone marrow (BM) were analyzed and compared.[Methods] 10% of YS-SCCM,FL-SCCM or BM-SCCM was added to culture system for differentiation of ES cells.Flow cytometric analysis was used to identify expression of Flk1,Integrin α4,Sca-1,and CD34.Colony analysis was used to identify the quantity of high proliferative potential colony-forming cells (HPP-CFC) in differentiated ES cells.The yield of CFU-S (colony-forming unit-spleen) was also analyzed by transplanting ES cell derivatives into lethally irradiated mice.[Results] Expression of Flk1,Integrin α4,Sca-1,and CD34 could be tested on induced EB cells.The percentage of Flk-1+,Integrin α4+ and Sca-1+ cells induced by were 3.03%,2.9%,and 13.74%,respectively,which are greater than other groups.The percentage of CD34+ cells induced by BMSC-CM was 1.07% which was greater than other groups.The yields of HPP-CFC from hematopoietic cells induced by FLSC-CM or BMSC-CM were 7.4 /105 cells (P ＜ 0.01) and 5.8 /105 cells (P ＜ 0.05) which were greater than the yields of control group.The yields of CFU-S from hematopoietic cells induced by FLSC-CM or BMSC-CM were 8.5/5 × 105 cells and 6.75/5 × 105 cells which were also greater than the yields of control group (P ＜ 0.001).[Conclusion] Both YS-SCCM,FL-SCCM,and BM-SCCM could promote hematopoietic differentiation of ESE14.1 cells.Hematopoietic differentiation induced by FL-SCCM or BM-SCCM is more effective,which generates hematopoietic progenitor cells with normal function.Application of FL-SCCM generates more primitive hematopoietic progenitor cells than that of BM-SCCM.
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Objective To investigate hepatic pathohistological changes(including pathology,HBV markers in liver tissue)in patients with KBeAg negative chronic hepatitis B after adefovir therapy for 1 year.Methods 35 patients with HBeAg negative chronic hepatitis B were administered with 10mg adefovir once a day for one year.The needle biopsy of liver were performed before and after treatment.The routine HE stained liver tissue sections were evaluated and Knodell pathological score were done.HBsAg and HBeAg in liver tissue were examined by immunohisochemisty method.Results After 1 year,18,17 and 11 cases had a significant reduction of their total hepatic HAI score,necroinflammation and fibrosis score.The immunohistochemistry examination showed HBeAg in liver decreased significantly,but HBsAg had no obvious alteration.Conclusion Significant improvement in both necroin flammation and fibrosis can be obtained in the majority of patients treated with adefovir for 1 year.More significant improvement in live histology can be obtained after extended treatment.
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AIM: To establish hybrid mouse embryonic stem (ES) cell line from blastocysts of the (C57BL/6J × 129/J) F1 mouse. METHODS: 3.5 days post- coitus (d.p.c.) blastocysts were cultured on mouse embryonic fibroblasts (MEFs) in the medium, after 3 - 4 days, Inner cell mass were picked up and disaggregated, then reseeded. After the ES - like colonies appeared, passaged them to give permanent ES cell lines. The pluripotent propertes of ES cells obtained were analyzed by alkaline phosphatase (AKP) activity, expression of SSEA- 1 and Oct-4, and their capacity to form teratoma. RESULTS: Two hybrid ES cell lines, SC1001, SC1002 were obtained from blastocysts of the (C57BL/6J × 129/J) F1 genotype. Most of these ES cells had a normal karyotype and an XY sex chromosome composition. The pluripotent properties of the cell lines were analyzed on the basis of their alkaline phosphatase activity, expression of SSEA - 1 and Oct - 4, and their capacity to form teratoma in severe combined immunodeficiency (SCID) mice. CONCLUSION: Two hybrid mouse ES cell lines having pluripotent properties and capacity for long - term self renewal were generated from blastocysts of the ( C57BL/6J × 129/J) F1 genotype.
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Objective To explore the role of transcription factor activator protein 2?(AP-2?) on the expression of tyrosine hydroxylase(TH) in noradrenergic neurons of locus ceruleus(LC) after traumatic brain injury.Methods Oinety rats were!randomly divided into control group and injury group that comprised 5 subgroups.There were 15 rats in each group.The rat model of traumatic brain injury was established with Feeney's methods.Brain stems were dissected from decapitated heads 1,3,6,24 and 72 h after traumatic injury and freeze-mounted for cryo-sectioning.TH and AP-2? expressions in noradrenergic neurons of LC were analyzed with double immunofluorescence.Results The number and fluorescence intensity of TH and AP-2?-positive neurons in LC at various intervals after injury significantly increased as compared with control group(P
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Objective To investigate the changes of dopamine-?-hydroxylase(DBH) and activator protein 2-?(AP-2?) expression in spinal cord under the condition of stress or pain stimulation,so as to explore the mechanism for changes of noradrenergic(NA) neurons in the spinal cord of rat pain model.Methods Immunohistochemical staining,double immunofluorescent staining,Western blotting and computing-image analysis system were used to detect the changes of DBH/AP-2? expression in the spinal cord of formalin-induced rat pain model.Results A small number of DBH-positive neurons were sparsely distributed in the ventral horn of the normal spinal cord,while in the formalin-treated group,much more darkly-stained DBH-positive neurons appeared primarily in the ventral horn,intermediate zone,and the dorsal horn,which reached the highest level on day 3 after formalin-injection.The grey value and number of DBH-positive neurons on day 7 after injection began to decrease,but still higher than that in the control group.Compared with control group,the number of noradrenergic neurons in spinal cord of formalin-treated rat was increased significantly,which was also confirmed by Western blotting.Double immunofluorescent staining showed that DBH and AP-2? co-existed in the cells of the spinal cord.The changes of AP-2? expression were similarly to that of DBH in the spinal cord of rat pain model.Conclusion Our results indicated that some non-noradrenergic neurons with different chemical properties might convert into noradrenergic neurons under pain stimulation;noradrenaline may be involved in the formalin-induced pain and behavior regulation;As one of transcription factors,AP-2? may promote the DBH synthesis.