A novel nude mouse model for studying the pathogenesis of endometriosis.

Endometriosis is a common female gynecological disease that is characterized by the presence of functional endometrial tissue outside the uterine cavity. At present, many animal models have been established. However, previous studies consistently use human endometrial tissue implanted in the subcutaneous or abdominal cavity for modeling and rarely use endometrial cells. In the present study, we ascertained whether immortalized stromal and/or epithelial endometrial cells are able to induce subcutaneous endometriosis in nude mice. Mixed human immortalized endometriosis stromal and epithelial cells, but not the cells of Group 1 or Group 2, were successfully constructed and led to endometriotic-like lesions. The endometriosis-like lesions observed in nude mice consisted of endometriosis-like glands lined with columnar epithelial cells and surrounded by stromal cells in the fibrous fatty connective tissue. Immunofluorescence analysis showed that glandular epithelial cells were intensely stained for E-cadherin and cytokeratin 7, and surrounding stromal cells were mildly stained for neprilysin (CD10) and vimentin. Moreover, the cells present in the endometriosis-like lesions were of human origin. Our data indicate that the mixture of human immortalized endometriosis stromal cells and epithelial cells is able to establish subcutaneous endometriosis lesions in nude mice. This model could be used to understand the molecular mechanisms involved in the occurrence and development of endometriosis.

Effect of acupressure on postpartum low back pain, salivary cortisol, physical limitations, and depression: a randomized controlled pilot study.

OBJECTIVE: To investigate the effect of acupressure on postpartum low back pain (LBP), salivary cortisol, physical limitations, and postpartum depression. METHODS: Participants were 70 postpartum women who were randomly assigned to either an intervention (n = 35) or a control (n = 35) group. The intervention group received 10 acupressure sessions (1 session per day, 5 d per week). The control group received 10 sham acupressure sessions. Outcomes were assessed using a visual analogue scale (LBP intensity), salivary cortisol values (LBP biomarker), and Chinese versions of the Roland-Morris Disability Questionnaire (daily activity limitations), Oswestry Disability Index (physical activity limitations), and the Edinburgh Postnatal Depression Scale (postpartum depression). RESULTS: Participants in the intervention group had significantly lower levels of LBP intensity, daily activity limitations, physical activity limitations, and postpartum depression than those in the control group. There was no significant between-group difference in salivary cortisol. CONCLUSION: Acupressure may reduce postpartum LBP intensity and limitations in daily and physical activity, and alleviate postpartum depressive symptoms. Acupressure should be offered in postpartum care settings as an alternative treatment for postpartum women with LBP.

[The Effects of a Mobile Application Social Support Program on Postpartum Perceived Stress and Depression].

BACKGROUND: Postpartum depression is a common health problem for women following childbirth. Using effective social support to reduce postpartum depression has become an important issue. The current popularity of smartphones offers new possibilities for interventional methods. PURPOSE: To investigate the effects of mobile-application-based social support programs on perceived stress and postpartum depression in postpartum women. METHODS: The present study employs an experimental research design. 126 smartphone users at 36 weeks' gestation were assigned randomly to the intervention (n = 61) or the control (n = 65) group. The intervention group received a social-support intervention via the mobile application Line twice per week for a period of 4 weeks after childbirth. The control group did not receive the intervention. The Perceived Stress Scale-Chinese version and Edinburg Postnatal Depression Scale were used to evaluate the outcome. RESULTS: Participants in the intervention group had significantly lower perceived stress (F = 27.25, p < .001) and postpartum depression (F = 35.73, p < .001) than their control group peers. CONCLUSIONS: Social-support programs that are delivered via mobile applications such as Line may significantly reduce the perceived stress and postpartum depression of women during the early postpartum period. The results support the implementation of mobile-application-based social support programs in postpartum care.

Surgical resection improves the survival of selected hepatocellular carcinoma patients in Barcelona clinic liver cancer stage C.

BACKGROUND: Sorafenib is the only approved agent recommended by the American Association Study of Liver Disease guidelines for hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C. AIMS: To calculate and compare overall survival rates in hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C treated with various therapies or supportive care alone. METHODS: This was a retrospective study, in which medical data from 411 newly diagnosed hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C and Child-Pugh class A were analyzed and compared. RESULTS: Eighty-eight patients were treated with supportive care and 323 were treated with surgical resection (68/323, 21.1%), local ablation therapy (8/323, 2.5%), transarterial embolization (140/323, 43.3%), systemic chemotherapy or radiotherapy (96/323, 29.7%), and sorafenib (11/323, 3.4%). Median survival was 11 months (95% confidence interval, 9.0-13.1) in treated patients compared with 3.9 months in the supportive care group (hazard ratio, 0.45; 95% confidence interval, 0.35-0.59; p<0.001). Patients who underwent surgical resection had the longest survival compared to patients undergoing other treatments (33.4 months versus 8.1 months, p<0.001). CONCLUSIONS: Surgical resection resulted in excellent outcomes. Although sorafenib is currently recommended, oncologists should endeavour to select optimal candidates for surgical resection to gain more survival benefit.

Outcomes of continuing education in the care of children with asthma for pediatric healthcare providers.

In this study, the authors assessed the knowledge of healthcare providers regarding asthma care, examined the outcomes of continuing education for asthma care, and explored the relationships among demographic characteristics of the healthcare providers and the improvement in asthma care knowledge. Thirty-one pediatricians and 38 nurses in the pediatric units of a medical center completed a questionnaire before and after an asthma care program. Pediatricians and pediatric nurses provided correct answers to asthma care questions 84.45% and 61.97% of the time, respectively, before the program and 93.06% and 88.03% of the time, respectively, after the program, which was a significant improvement (p < .001). No significant correlations or differences were found between the changes in asthma care knowledge and the demographic characteristics of healthcare providers. Results from this study suggest that continuing education can improve the knowledge of asthma care among pediatric healthcare providers.

Stress response to hepatectomy in patients with a healthy or a diseased liver.

Partial hepatectomy is a major upper abdominal operation associated with certain stress to the patient. Successful adaptation to such stress is a prerequisite for survival. Donor hepatectomy with maximal safety is a principal concern during living donor liver transplantation. The purpose of the study was to compare the stress response by assessing cytokines and the acute-phase response induced by hepatectomy in patients with a healthy liver and those with a diseased liver. Fourteen patients undergoing partial right hepatectomy were enrolled in this study. Seven of them were donors for living related liver transplantation (group 1, or GI); the other seven were patients with hepatocellular carcinoma due to chronic hepatitis B (Child's class A) (GII). Blood samples for interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFalpha), and C-reactive protein (CRP) assays were collected before the operation, at the beginning and end of the operation, and 24 and 48 hours after the operation. The data were analyzed and compared in the same group using the Friedman test and between groups using the Mann-Whitney U-test. A value of p < 0.05 was regarded as significant. Results showed that resection of the liver in patients with both healthy and disease livers leads to significant increases in IL-6 and CPR but not TNFalpha. Significantly lower levels of IL-6 before and after operation in GI patients compared to those in GII patients suggests that GI patients adapted to surgical stress more easily than did the GII patients.

Retrobulbar cellular schwannoma. Two cases report and review of the literature.

Cellular schwannoma is a variant of classical schwannoma that is characterized by high cellularity. As it is accompanied by mitotic figures, it is easily mistaken for a malignant neoplasm. However, hyalinized thick-walled blood vessels, an alternating growth pattern of spindle-shaped neoplastic cells, and even Verocay bodies can be found. It is most commonly seen in the paravertebral area, particularly in the mediastinum and retroperitoneum. Retrobulbar cellular schwannoma is uncommon, and only one case has been reported to date. In this study, we report two additional cases of retrobulbar cellular schwannoma that recurred two years after surgery. We suggest that the patient be given an aggressive postoperative treatment because a successful, complete excision cannot be guaranteed at such an anatomic site.

The effect of hypernatremia on liver allografts in rats.

UNLABELLED: Hypernatremia in the donor organ is one of the most dangerous risk factors that may cause primary graft loss after orthotopic liver transplantation (OLT). However, the viability of donor grafts from acute hypernatremic donors, which is likely to occur during resuscitation of trauma patients with hypertonic saline solution, has not been studied precisely. In the present study, we sought to evaluate whether the hypernatremia, per se, induced by hypertonic saline solution, affects the outcome of liver transplantation in the normal rat. Thirty minutes after the induction of hypernatremia (>160 mEq/L), the livers of nine Wistar rats were removed under ether anesthesia. Six livers were immediately transplanted into normal Wistar rats, whereas the other three were preserved in 4 degrees C University of Wisconsin solution for 6 h before transplantation in the recipients. Liver function variables of the donor rats at graft procurement and of the recipients at Day 7 after OLT were compared with a control group. The water content of the graft at procurement and the survival of the recipients at 7 days after OLT were, likewise, compared with the untreated control group. Results showed that there were no significant differences in the liver function tests of the donors and recipients, as well as in the water content of the grafts, between groups. All the rats survived the observation period of 7 days. This study showed that acute hypernatremia induced by the infusion of 10% saline solution before graft procurement in a nonbrain-dead donor rat model did not lead to a deterioration of liver graft viability after OLT. IMPLICATIONS: Hypernatremia in cadaveric donors may be detrimental to the graft in clinical liver transplantation, but acute donor hypernatremia induced by an IV infusion of 10% saline solution before graft procurement in nonbrain-dead rats did not affect the survival of the recipient rats in an experimental liver transplantation model.