Replantation of severed auricle distal to helix with microsurgical technique: Report of 5 cases / 中华显微外科杂志

Objective:To summarise the clinical experience in replantation of the severed auricle distal to helix with microsurgical technique.Methods:From December 2018 to October 2021, a total of 5 patients with severed auricle injury were treated in the Department of Hand and Foot Surgery of The Affiliated Hospital of Qingdao University. They were 4 males and 1 female with 23-62 years old. After complete debridement of the auricular pinna, the retrograde replantation method was used. For arteries: a dorsal vein of the foot was used to bridge the posterior auricular artery. For veins: 2 patients had the veins directly anastomosed, 2 had the arteriovenous bridging to the posterior ear vein with dorsal foot veins, and the veins in 1 case were not anastomosed. Among the patients, 2 developed venous occlusions after severed auricle, and were treated with bloodletting through small incision at the skin margin. Two patients who received the arteriovenous of the severed auriclse achieved good blood supply. All the patients underwent treatments including anti-freezing, anti-spasm and anti-infection after the emergency surgery. The follow-ups were conducted regularly by telephone and by display photos via WeChat after surgery.Results:All 5 severed auricles were successfully replanted and survived. Postoperative follow-up ranged from 3 months to 2 years, with an average of 10 months. In the 2 cases with venous crisis, the auricles had mild atrophy. All auricles had no obvious pigmentation, and had the sensation recovery back to normal in 1 year after surgery.Conclusion:The pre-judgment of blood vessel quality and high-quality microsurgery skills are the necessary pre-conditions for auricle replantation. For replantation of severed auricle, it is the key to prevent vascular crisis by having the injured blood vessels thoroughly removed.

Analysis of pain knowledge, belief, behavior level and influencing factors of cancer pain patients / 中国实用护理杂志

Objective:To understand the pain knowledge, belief and behavior level of cancer pain patients, analyze the influencing factors.Methods:A total of 176 patients with a convenient sampling method selection on November 20, 2021 in Ningxia medical institutions that have created cancer pain in the treatment of cancer pain in Ningxia as the research object of cancer pain in medical institutions, and use the "Cancer Pain Pain Incarring Credit Council Cancer Question Question" that is designed and examined by self-examination.Results:The pain knowledge dimension score of cancer pain patients in Ningxia was 5.00 (4.00, 6.00), the belief dimension score was 3.00 (-3.00, 10.00), and the behavior dimension score was 26.00 (24.00, 28.00). The results of multiple linear regression showed that financial burden and burst pain were the factors affecting the pain belief and perception of cancer pain patients ( t=-2.96, -3.00, both P<0.05). The type of medical insurance and the duration of pain were the factors affecting the behavior of pain ( t=-2.49, 3.21, both P<0.05). Conclusions:Cancer pain patients have a low level of pain knowledge, an upper-middle level of negative pain beliefs and perceptions, and a moderate level of pain behavior. It is recommended that nursing personnel use the discharge plan service as the main line to build a full-process management model of cancer pain. During the hospitalization period, pay attention to the outbreak of pain and psychological conditions, and gradually improve the quality of health education through nursing quality evaluation. After discharge, pay attention to the practicality and long-term development of continuity health education, and promote the full management of patients with cancer pain.

Comparative study on metastatic lymph node radio and pathological lymph node stage in prognosis evaluation of patients with gastric cancer after radical resection / 中华内分泌外科杂志

Objective:To study the value of metastatic lymph node radio (rN) and pathological lymph node stage (pN) in evaluating the prognosis of patients after radical gastric cancer.Methods:The clinicopathological data of 491 patients who underwent radical gastrectomy in Tantai Yantaishan Hospital from Jan. 2013 to Dec. 2017 were retrospectively analyzed. X-tile software was used to group the metastatic lymph node radio by rN. According to the number of lymph node metastasis, pN stage was performed. The correlation between metastatic lymph node radio and other clinicopathological factors was assessed. The metastatic lymph node radio and the pathological lymph node stage in evaluating the prognosis of patients after radical gastric cancer were compared.Results:(1) X-tile analysis showed that the best cut-off values for the metastatic lymph node radio in this study were 0.14 (14%) and 0.63 (63%) . (2) According to the cut-off value, the 491 patients included in the study were divided into rN1 (256 cases) , rN2 (160 cases) , and rN3 (75 cases) three subgroups. The results of the analysis of differences showed that there were significant differencesbetween the groups in terms of tumor diameter, tumor location, surgical resection range, stage, lauren classification, degree of differentiation, pT, pN, vascular cancer emboulus, nerve invasion, and pathological TNM staging groups. (3) Comparison of rN and pN staging in evaluation of the prognosis of patients after radical gastric cancer: ①Kaplan-Meier survival analysis results showed that rN was better than pN. ② Both single factor and multivariate cox analysis showed that rN was an independent risk factor for the prognosis of gastric cancer. In univariate analysis, rN group HR=3.18 (95% CI 2.63-3.84, P<0.001) , pN stage HR=1.88 (95% CI 1.66-2.15, P<0.001) ; rN group HR=2.21 in multivariate analysis (95% CI 1.73-2.82, P<0.001) , pN staging HR=1.31 (95% CI 0.95-1.79, P=0.095) . ③The time-dependent ROC analysis showed that the prognostic ability of rN was better than pN staging before 52 months of postoperative follow-up, and pN staging was more advantageous after 52 months. ④The Lauren classification was used as a stratification factor for stratified analysis. The Kaplan-Meier survival curve indicated that rN was better than pN staging in intestinal, mixed and diffuse gastric cancer, and the AUC curve showed the prediction of rN in patients with mixed and diffuse gastric cancer was better than pN staging, while pN staging performance was slightly better in patients with intestinal gastric cancer. Conclusions:rN is an independent factor affecting the prognosis of patients after radical gastric cancer surgery. When judging the prognosis of patients within 52 months after radical gastric cancer, rN has a better prognostic value than pN. In patients with mixed and diffuse gastric cancer in the Lauren classification, rN shows better prognostic value.

Endoscopic mucosal resection for gastrointestinal neuroendocrine tumors with diameter≤10mm: a retrospective analysis of 40 cases / 中华内分泌外科杂志

Objective:To investigate the safety and reliability of endoscopic mucosal resection (EMR) in the treatment of gastrointestinal neuroendocrine tumors (GI-NETs) with a diameter of ≤10mm.Methods:From February 2015 to June 2019, 40 cases of gastrointestinal neuroendocrine tumors with a diameter of ≤10mm underwent EMR in Yantaishan Hospital of Yantai City were retrospectively analyzed to evaluate the safety and reliability of EMR surgery.Results:All 40 cases were performed endoscopically by EMR. The en bloc resection rate and RO resection rate reached 100%. The lesions were all confined to the submucosa and did not infiltrate the muscularis propria. Postoperative pathological classification: NET G1: 35 cases, NET G2 grade: 5 cases, no NET G3 grade cases. There were no complications such as bleeding and perforation during and after the operation. Follow-up: 1 case was lost to follow-up, 1 patient died of other diseases, and the remaining 38 cases were followed up for an average of 27.8 months (5-46 months) without local recurrence or distant metastasis.Conclusion:For well-differentiated G1 and G2 gastrointestinal neuroendocrine tumors with a diameter ≤10mm, EMR is a safe and reliable treatment.

Clinicopathological features of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract: a report of five cases / 中华病理学杂志

Objective@#To investigate the clinicopathological features of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract.@*Methods@#Five cases of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract from the Affiliated Hospital of Qingdao University from 2016 to 2019 were retrospectively reviewed. The clinical and pathological parameters were analyzed by combining clinical data and reviewing the available literature of 35 cases (34 cases abroad and 1 case in China).@*Results@#There were 4 males and 1 female with a median age of 47 years (18-66 years). All patients had abdominal pain and constitutional symptoms including diarrhea, emaciation, intermittent mucous stool or oral and epiglottic ulcers. Endoscopic manifestations included multiple punctate congestion, erosion and ulcer at the terminal ileum and colorectum. Two cases had congestion and erosion of antrum and angle of stomach, and the lesions did not fuse and form tumors. Histologically, the lamina propria was expanded by a dense, medium to small lymphocyte infiltration, which was monomorphic, with slightly irregular nuclei without prominent nucleolus or lymphoepithelial lesions. There were admixed small amount of plasma cells and eosinophils. In 4 cases, immunohistochemistry showed the lesional cells were positive for CD3, CD8, TIA1, and negative for CD4, CD56, granzyme B and Ki-67 index was ≤10%. In situ hybridization showed that EBER was negative and clonal TCR gene rearrangement was detected. One consultation case was CD3+, CD5- and Ki-67 index of 10%, although other indicators were not done. All five patients were treated with symptomatic support. In follow-up observation for 2 to 25 months, all patients were alive with the disease.@*Conclusions@#Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract is a newly classified monoclonal T-cell proliferative disease, with low incidence, clinical inertia and long-term survival. It has unique clinicopathological features but pathologically it is easily misdiagnosed as inflammatory bowel disease or T-cell lymphoma. Correct diagnosis is of great important clinical significance.

Clinical application of convolutional neural network in pathological diagnosis of metastatic lymph nodes of gastric cancer / 中华外科杂志

Objective@#To examine the value and clinical application of convolutional neural network in pathological diagnosis of metastatic lymph nodes of gastric cancer.@*Methods@#Totally 124 patients with advanced gastric cancer who underwent radical gastrectomy plus D2 lymphadenectomy at Affiliated Hospital of Qingdao University from July 2016 to December 2018 were selected in the study. According to the chronological order, the first 80 cases were served as learning group. The remaining 44 cases were served as verification group. There were 45 males and 35 females in the study group, with average age of 57.6 years. There were 29 males and 15 females in the validation group, with average age of 9.2 years. The pre-training convolutional neural network architecture Resnet50 was trained and fine-tuned by 21 352 patches with cancer areas and 14 997 patches without cancer areas in the training group. A total of 78 whole-slide image served as a test dataset including positive (n=38) and negative (n=40) lymph nodes. The convolutional neural network computer-aided detection (CNN-CAD) system was used to analyze the ability of convolutional neural network system to screen metastatic lymph nodes at the level of slice by setting threshold, and evaluate the system′s classification accuracy by calculating its sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic curve (AUC).@*Results@#The classification accuracy of CNN-CAD system at slice level was 100%.The AUC for the CNN-CAD system was 0.89. The sensitivity was 0.778, specificity was 0.995, overall accuracy was 0.989. Positive and negative predictive values were 0.822 and 0.994, respectively. The CNN-CAD system achieved the same classification results as pathologists.@*Conclusions@#The CNN-CAD system has been constructed to distinguished benign and malignant lymph node slides with high accuracy and specificity. It could achieve the similar classification results as pathologists.

Variation of Surface Electromyogram with Manipulation of Tuina for Stroke Hemiplegics / 中国康复理论与实践

Objective To compare the effect of various manipulation of Tuina on surface electromyogram (sEMG) in hemiplegics after stroke. Methods From January to May, 2016, 20 inpatients with hemiplegia after stroke accepted Tuina on bilateral rectus femoris by the same therapist, with the techniques of rolling, patting, rubbing, shaking, kneading and pressing, one minute a manipulation and interval one minute. Integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) of sEMG were compared, both in rest and during Tuina. Results There was no significant difference of iEMG, RMS and MF between affected and unaffected sides in rest (t0.05). iEMG and RMS were the most under patting (F>21.376, P11.772, P0.05). iEMG and RMS were less in the affected side than in the unaffected side under patting (P<0.05). Conclusion Various manipulation of Tuina may be different in neuromuscular stimulation, that patting may stimulate more muscles and motor units.

Clinical research of needle-pricking therapy for functional retrograde ejaculatioin / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week. In the control group, midodrine tablets were prescribed orally,three times a day. All the treatment was given for 9 weeks. The clinical effects of the two groups were observed, and the levels of luteinizing hormone(LH), testosterone(Tes) and estra4 diol(E2) were compared between the two groups.</p><p><b>RESULTS</b>The total effective rate of the observation group was, 89. 47%(17/19), which was better than 47.06% (8/17) of the control group(P<0. 05). The LH and Tes were obviously increased and E2 was decreased compared with those before treatment in the observation group(all P< 0. 01). Tes was raised(P<0. 05) and E2 was apparently declined in the control group(P<0. 01). After treatment, the differences of serum LH and Tes were statistically significant between the two groups(both P<0. 01).</p><p><b>CONCLUSION</b>Needle-pricking therapy has advantages for functional retrograde ejaculation probably in that stimulating lumbosacral nerves can strengthen the function of pelvic floor muscles and urethral expansion muscle and regulate sexual gland axis.</p>

Effects of p38 MAPK signaling pathway and aldose reductase on transforming growth factor-β1 induced expression of fibronectin in cultured human mesangial cells / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the effects of p38 MAPK signaling pathway and aldose reductase (AR) on the transforming growth factor (TGF)-β1-induced expression of fibronectin (FN).</p><p><b>METHODS</b>Human mesangial cells (HMCs) were cultured, and transfected with pCDNA3-AR. AR gene silencing was induced by small interfering RNA (siRNA). AR expression in HMCs was examined by immunofluorescence analysis. RT-PCR and real-time PCR were performed to detect the mRNA expression of AR in the HMCs and Western blotting was used to detect the protein expression of AR, FN and p38. AR inhibitors (ARIs), Sorbinil and Zopolrestat were added and co-incubated, followed by addition of TGF-β1. Western blotting was used to document protein expression of FN and p38 mitogen-activated protein kinases (p38 MAPKs) in the HMCs.</p><p><b>RESULTS</b>Immunofluorescence analysis showed a stronger expression of AR in HMCs transfected with AR than that of normal HMCs and HMCs transfected with blank vector. In comparison with normal HMCs and those transfected with blank vector, HMCs transfected with AR showed stronger protein expression of FN (P<0.05). After incubation of ARIs, protein expression of FN decreased in HMCs transfected with AR (P<0.05). After stimulation of TGF-β1, FN protein expression increased in both normal HMCs and those transfected with AR (P<0.05). After preincubation with ARI, FN protein expression in HMCs transfected decreased significantly (P<0.05). After stimulation of TGF-β1, naïve HMCs showed increased expression of phosphor-p38. In contrast, HMCs preincubated with ARIs showed reduced expression of phosphor-p38, and HMCs transfected with AR showed increased expression of phosphor-p38 (P<0.05).</p><p><b>CONCLUSIONS</b>AR regulates the expression of FN through the stimulation of TGF-β1, which may involve the activation of p38-MAPK signaling pathway. AR may play a role in the pathogenesis of glomerulosclerosis.</p>

Survey of rescue posttraumatic growth of 424 Chinese people's armed forces soldiers / 中华行为医学与脑科学杂志

Objective To explore the status and influencing factors of the rescue posttraumatic growth of Chinese people' s armed forces soldiers in order to provide a new point of view for psychological intervention.Methods 424 soldiers who had executed earthquake rescue task were assessed with Posttraumatic Growth Inventory (PTGI),and the growth status between different groups were compared.Results (1) The average score of PTGI 21 items ranged from 2.72-3.72,and the score of most items were above 3,which implied the growth degree was between middle change and more change.8 items with highest score were focused on three dimensions which were labeled interpersonal relationship,appreciation of life and personal strength.(2) There was no significant difference between the total score of different rank groups (F=0.885,P＞0.05),which score were 3.43±0.66,3.50±0.62,3.50±0.79,3.30±1.11 respectively.The was significant difference in 4 dimensions and total score of PTGI between the group which had executed rescue task for more than 14 days and the other which had executed rescue task for less than 14 days,and the scores of the group which had executed rescue task for more than 14 days were higher (P＜0.05 or 0.01).Conclusion Almost all rescue soldiers perceives mental growth,such as the changes of interpersonal relationship,attitude of life,and personal strength particularly.The duration of rescue task might be a influencing factor of posttraumatic growth.

Cloning, expression and screening tandem repeats of the Z domain of Staphylococcus aureus protein A / 生物工程学报

To screen an efficient recombinant Staphylococcus aureus protein A (SpA) for preparing matrix for affinity purification of immunoglobulin G (IgG), a genetic engineering approach was used to obtain monomer, two, three, four and five tandem repeats genes of the Z domain of SpA, then the genes were cloned into expression vector pET-22b and subsequently expressed in Escherichia coli BL21 (DE3). After induction with lactose, the target proteins were purified by Ni2+ affinity chromatography. The proteins with two, three, four and five tandem repeats of the Z domain were then coupled to CNBr-activated Sepharose 4B as an affinity chromatography matrix for affinity purification of human IgG. Furthermore, the differences in protein yield and IgG-binding capacity at different recombinant proteins were analyzed. The target proteins with monomer and tandem repeats of the Z domain had an effective expression in the genetic engineering bacteria. IgG could be specifically absorbed from human plasma by affinity chromatography. The protein yield and amount of IgG absorption of per mole protein could be improved by increasing the tandem repeats number of the Z domain. Compared with other tandem repeats, four tandem repeats of the Z domain exhibited more protein yield (160 mg/10 g wet cells) and higher level of IgG absorption (34.4 mg human IgG/mL gel). Therefore, four tandem repeats of the Z domain is more suitable for preparing matrix for affinity purification of IgG.

Research on the acculturation of Pakistani medical students in China / 中华医学教育探索杂志

The article analyzed the impact of cultural differences factors and non-cultural factors on cross-cultural adaptation of Pakistani medical students from the following aspects:daily habits,language,religion,values,China's laws and regulations,service mode of social life,curriculum setting,universities' management mode,adolescent growth factors,learning methods and learning ability,higher education and primary education teaching methods,difference between traditional and modern Chinese.Some recommendations were given from several aspects,such as enrollment,management,policy formulation and adolescent education.

Exploration on humanistic education into the teaching of physiology for nursing students / 中华医学教育探索杂志

To cultivate high quality nursing personnel,it is necessary to put significant emphasis on humanistic education.The combination of physiology teaching and humanistic education for nursing students was discussed in this article.In teaching practice,professional knowledge and humanistic quality of nursing students could be improved through various ways,including enhancing humanistic quality of teachers,establishing people oriented teaching philosophy,introducing history of science,carring out research-based learning projects.

Criterion-related validity of the competency model of armed police sergeant / 中华行为医学与脑科学杂志

Objective To examine the Criterion-related validity of the competency model of armed police sergeant.Methods 513 armed police soldiers were evaluated by 2 leaders with competency model of armed police sergeant.5 equidistant grades rating method was used.The list of excellent soldiers were collected.Results ( 1 ) There were significant differences on 17 items of competency scores between excellent soldier group and average soldier group (P ＜ 0.05 ), except for one item of competency.Furthermore, there were significant differences on 4 factor scores and sum scores between excellent soldier group and average soldier group (P ＜ 0.05 ).( 2 ) The predictive probability were 72.6 % (A) ,71.3% (B) predicting excellent soldiers by the sum scores of competency model.Conclusion The Criterion-related validity of the competency model of armed police sergeant is acceptable.It can be used in the selecting and training of armed police sergeant.

Effect of ERK signalling pathway and aldose reductase on the expression of fibronectin induced by transforming growth factor β1 in human mesangial cells / 中华肾脏病杂志

Objective To study the effect of ERK signalling pathway and aldose reduetase(AR)on the transforming growth factor-β1(TGF-β1)-induced expression of fibronectin (FN)in nondiabetic nephropathy. Methods Human mesangial cells(HMCs)were cultured and transfected with pCDNA3-AR and AR gene silencing with small interfering RNA(siRNA).The AR expression in the HMCs was examined by real-time PCR and Western blotting was used to detect the protein expression of AR and FN. Inhibitors of AR and ERK signalling pathway were co-cultured with HMCs, then TGF-β1 was added and Western blotting was used to analyze the protein expression of FN. Results The expression of AR, FN and p-ERK was up-regulated by TGF-β1. AR was increased by 1.8-fold, FN was increased by 1.9-fold (P＜0.05), and p-ERK was increased by 5.l-fold after stimulation with TGF-β1 (P＜0.01). HMCs transfected with AR showed stronger protein expression of FN, more than 3.6-fold in the protein level of FN was observed in HMCs (P＜0.05). The HMCs of knockdown AR gene by siRNA showed decreased expression of AR,FN and p-ERK, the level of AR mRNA in HMCs transfected with AR siRNA was 10% of the level in untransfected cells or cells transfected with control siRNA (P＜0.01). Transfection with AR siRNA attenuated TGF-β1-induced FN production, more than 70% decrease in the protein level of FN and p-ERK was observed in HMCs with AR-siRNA (P＜0.01). Conclusions AR can regulate the expression of FN with the stimulation of TGF-β1, as AR gene is one of the responsive genes of TGF-β1, which may be associated with the activation of ERK signalling pathways induced by TCF-β1.

Differential effects of morphine on conditioned place preference and locomotor activity in adult and adolescent rats / 中华行为医学与脑科学杂志

Objective To test whether adolescent rats are more sensitive than adult rats to morphine' s rewarding actions and locomotor activating effects. Methods Conditioned place preference(CPP) procedure was used to examine drug-induced reward and locomotor activity. Adolescent ( Postnatal day 35 ) and adult ( P67 ) male rats received either saline or morphine (3 mg/kg) for 6 days and the locomotor response in the drug paired chamber was recorded during conditioned training. CPP effects were tested 24h after the last training. Results In adolescent rats, morphine CPP effect was not present [ saline group (20. 89 ±31. 14) s, morphine group (90. 75 ± 27.91)s, P = 0. 15], however, morphine CPP effect occurred in adult rats[saline group (31.5 ± 41. 24) s, morphine group(266. 13 ± 32. 26) s, P < 0. 001 ]. Adult rats presented higher CPP score than adolescent rats(P < 0.001). The locomotor response was significantly higher in day 3 ～ 6 than day 1 in the adolescent treated with morphine (P<0.05 or <0. 01). The locomotor response was significantly higher in day 2-6 than day 1 in the adolescent treated with morphine(P<0. 05 or < 0. 01 ) .which suggested that both adolescent and adult rats exhibited similar behavioral sensitization to morphine administration. Two-way ANOVA indicated that the main effect of age was not significant(F_(1,14) =0. 33, P = 0. 57) ,the interaction effect of age x treat was not significant(F_(5,70) = 0.85, P = 0.52) .there was no age difference between adolescent and adult rats in behavioral sensitization effects. Conclusion Compared with adult rats, adolescent rats don' t present morphine CPP, but show the similar morphine behavioral sensitization.

Effects of the supine and prone rest postitions on gastrointestinal pe ristaltic function in premature infants / 中华护理杂志

Objective: To observe gastrointestinal perista ltic function in premature infants in the supine or prostrate post itons .Methods: 24 premature infants were chosen and kept in the supine or pron e positions.Fluid retention volume in the stomach was recorded and compared statistically. Results:The prone group had a lower fluid retention volume.Ther e was a significant difference between the two groups (P<0.001 ). Conculsion:The prone position is a modera te position that improves premature infants' gastrointestinal peristalti c function,digestion and assimilation.

Cognitive Processes Bias of Self-referent Encoding Task in Depressive College Students / 中国临床心理学杂志

Objective: To test whether depressive college students had sociotropic self-schemata. Methods: A total of 500 college students were surveyed by CES-D and SAS, and 77 college students were chosen for further experiment: 24 with depressive mood, 12 with anxious mood, 17 with both depressive and anxious mood, and 24 normal ones. Sociotropic adjectives were strictly developed, and the 4 groups (depressive vs. anxious vs. depressive and anxious vs. normal) were given Self-referent Encoding Task. Results: ①The depressive group showed significantly less positive adjectives and more negative adjectives for self-descriptive than the normal group (P