Nurses' knowledge, attitudes, and willingness to practice hospice care: An analysis of influencing factors.

BACKGROUND: Hospice care is a multidisciplinary approach that focused on patients' quality of life, and nurses allocate more of their time with patients and patients' families than those nurses working in other disciplines. Nurses' knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China's hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses' willingness to practice hospice care are limited. METHODS: A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses' demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis. RESULTS: Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses' willingness to practice hospice care. CONCLUSION: This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses' knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.

Efficacy of Traditional Chinese Medicine on Animal Model of IgA Nephropathy: A Systematic Review and Meta-Analysis.

Objective: Traditional Chinese medicine (TCM) has a long history in the treatment of Immunoglobulin A nephropathy (IgAN). A large number of animal experiments focused on the TCM treatment of IgAN are conducted every year. The evidence for these preclinical studies is not clear. This study summarized and evaluated the results of animal experiments on TCM treatment for IgAN. Methods: We systematically searched animal studies from 6 databases from inception to August 30, 2022. We included Chinese studies from the key magazine of China technology. The quality of the included studies was evaluated with the SYRCLE animal experimental bias risk assessment tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Out of 832 records identified in the initial search, 30 studies were selected. The results indicated that, compared with the control group, the TCM treatment group improved 24 h urine protein (24 h-UP) level (standardized mean difference (SMD) 3.57, 95% confidence interval (CI) 4.48 to 2.66, P < 0.001), urine red blood cell (U-RBC) (SMD 13.66, 95% CI 17.99 to 9.32, P < 0.001), serum creatinine (Scr) (mean difference (MD) 10.89, 95% CI 17.00 to 4.77, P < 0.001), blood urea nitrogen (BUN) (MD 2.44, 95% CI 3.42 to 1.47, P < 0.001), tumor necrosis factor-α (TNF-α) (MD 171.28 to 95% CI 323.68 to 18.88, P=0.03), transforming growth factor-ß1 (TGF-ß) (SMD 4.02, 95% CI 7.26 to 0.77, P=0.02), matrix metalloproteinase-9/tissue inhibitors of metalloproteinase-1(MMP-9/TIMP-1) (MD 0.03, 95% CI 0.00 to 0.06, P=0.02), nephrin mRNA (SMD 3.39, 95% CI 2.59 to 4.18, P < 0.001). However, there is no difference in albumin level (MD 1.10, 95% CI 0.06 to 2.26, P=0.06) and interleukin-6 (IL-6) (MD 170.77, 95% CI 365.3 to 23.75, P=0.09). Conclusions: TCM can improve 24 h-UP, U-RBC, Scr, BUN, MMP-9/TIMP-1, TNF-α, TGF-ß, and nephrin mRNA of IgAN animal models. Moreover, there is a need for rigorous reporting of preclinical research methodology, which is essential to support the quality of preclinical research. Registration. This review was registered with a systematic review record CRD42020171404 in the PROSPERO database.

How much improvement can satisfy patients? Exploring patients' satisfaction 3 years after total knee arthroplasty.

BACKGROUND: Despite the innovations in total knee arthroplasty (TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients' satisfaction and identify minimal clinically important difference (MCID) and minimum important change (MIC) in clinical parameters. METHODS: We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from January 2017 to December 2017. We collected the following parameters: body mass index (BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores, and radiological parameters (preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage (0-100). RESULTS: We revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age, and pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. CONCLUSIONS: In summary, we identified several factors that correlated with patients' satisfaction independently after TKA in a long term. In addition, we revealed the minimal clinically important difference (MCID) and minimum important change (MIC) for HSS and NRS score in these patients.

Characteristics of corneal high-order aberrations in adolescents with mild to moderate myopia.

BACKGROUND: This study investigated the characteristics of corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea in adolescents with mild to moderate myopia. METHODS: A total of 183 patients with myopia (183 eyes) aged 8 to 18 years were enrolled in this study. The axial length (AL) of the eyes was measured by an IOL-Master, and corneal curvatures (K-values) and HOAs were measured by a Pentacam anterior segment diagnostic analyzer. RESULTS: Results of this study showed that the anterior, posterior and total corneal horizontal coma Z31 were - 0.1249 ± 0.105 µm, 0.0009 ± 0.001 µm, and - 0.1331 ± 0.116 µm, respectively; the anterior, posterior and total corneal vertical coma Z3- 1 were - 0.0212 ± 0.164 µm, 0.0003 ± 0.043 µm, and - 0.0216 ± 0.168 µm, respectively; and spherical aberration (SA) Z40 values were 0.2244 ± 0.091 µm, 0.1437 ± 0.029 um, and 0.1889 ± 0.090 µm, respectively. Total corneal Z31 was statistically correlated with posterior corneal astigmatism (K2b - K1b) (p = 0.038). Total corneal Z3- 1 was correlated with anterior corneal astigmatism (K2f - K1f) (p = 0.027). Anterior, posterior, and total corneal Z40 were correlated with anterior and posterior corneal curvature (K1f, K2f, K1b, K2b) (p = 0.001). Posterior corneal Z40b was also significantly correlated with AL. CONCLUSIONS: In adolescents with mild to moderate myopia, the posterior corneal surface shape may play a compensatory role in the balance of corneal aberrations, and the posterior corneal SA tended to become less negative as the AL increased. The corneal coma may also play a compensatory role in posterior corneal surface astigmatism, which was valuable for the treatment for improving visual quality. This conclusion still needs to be verified.

First report of a stunt nematode Tylenchorhynchus zeae on corn in Gansu Province, China.

During a survey of plant parasitic nematodes in 2019, at Gansu Province, China, the stunt nematode Tylenchorhynchus zeae was found parasitizing corn seedlings. Females, males and juveniles of T. zeae were observed on soil and roots samples of corn after processing and extraction. This population of stunt nematodes was identified based on morphological and by sequencing the ITS1 region of rDNA and D2/D3 fragments of the 28 S rRNA. The ITS1 and the D2/D3 sequences of this population, shared 99.00 to 99.05% and 99.43 to 99.73% of similarity with sequences corresponding to T. zeae in GenBank, respectively. This is the first report of T. zeae infecting corn in Gansu Province, northwest China.During a survey of plant parasitic nematodes in 2019, at Gansu Province, China, the stunt nematode Tylenchorhynchus zeae was found parasitizing corn seedlings. Females, males and juveniles of T. zeae were observed on soil and roots samples of corn after processing and extraction. This population of stunt nematodes was identified based on morphological and by sequencing the ITS1 region of rDNA and D2/D3 fragments of the 28 S rRNA. The ITS1 and the D2/D3 sequences of this population, shared 99.00 to 99.05% and 99.43 to 99.73% of similarity with sequences corresponding to T. zeae in GenBank, respectively. This is the first report of T. zeae infecting corn in Gansu Province, northwest China.

Comparison of Total Hip Arthroplasty after Two Types of Failed Hip Preserving Procedures with Primary Total Hip Arthroplasty.

OBJECTIVE: Porous tantalum implantation (PTI) and bone impaction grafting (BIG) through a window at the femoral head neck junction are known as two types of joint-preserving procedures. They provide an alternative option in the treatment of osteonecrosis of the femoral head by providing strong structural support to the subchondral plate. However, when earlier joint-preserving treatments fail, conversion to a total hip arthroplasty seems to be the final treatment of choice. This emphasizes the importance of joint-preserving procedures that do not hinder the clinical results of a subsequent total hip arthroplasty. The results of conversion total hip arthroplasty after failed PTI and BIG are still controversial. The purpose of this study was to compare the clinical and radiological outcomes of total hip arthroplasty after failed PTI or BIG surgery with primary total hip arthroplasty. METHODS: Patients at our institution between 2010 and 2014 who underwent total hip arthroplasty after failed PTI or BIG surgery compared to primary total hip arthroplasty were retrospectively reviewed. A total of 27 patients (30 hips) who underwent total hip arthroplasty after failed PTI surgery (group I) were matched according to age, gender and BMI index with 28 patients (30 hips) who underwent total hip arthroplasty after failed BIG surgery (group II) and 30 patients (30 hips) who underwent primary total hip arthroplasty (group III). The clinical results included preoperative and postoperative Harris Hip score, surgery duration, blood loss volume and clinical complications. Radiological follow-up results included abduction angle and anteversion angle of the acetabular cup, periprosthetic osteolysis, and prosthesis subsidence. RESULTS: There was no significant difference in the preoperative and postoperative Harris Hip score among the three groups at the latest follow-up (P = 0.247). The surgery duration was longer and intra-operative blood loss volume was higher in group I than in group II and group III (P < 0.05, respectively). There was no difference in surgery duration and blood loss volume between group II and group III (P > 0.05). There was no significant difference in radiological follow-up results among the three groups (P > 0.05). Varying degrees of residual tantalum debris were seen on postoperative radiographs of all group I patients. There was no difference in the incidence of complications among the three groups (P > 0.05). CONCLUSIONS: PTI group had higher blood loss volume and surgery duration than BIG group and primary total hip arthroplasty group. BIG group had no significant differences with primary total hip arthroplasty group in clinical and radiological follow-up results. There were no significant differences between the three groups in the Harris Hip score and radiological follow-up results.

An innovative three-dimensional method for identifying a proper femoral intramedullary entry point in total knee arthroplasty.

BACKGROUND:: Identification of the proper femoral intramedullary (IM) access point is an important determinant of final implant position in IM-guided total knee arthroplasty (TKA). The aim of this study was to identify the optimal entry point in Chinese participants using a new three-dimensional method. METHODS:: A series of computed tomography scans of 44 femurs in Chinese participants from October 2014 to October 2015 were imported into Mimics 17.0 software to identify the optimal entry point. The apex of the intercondylar notch (AIN) was used as the reference bony anatomical landmark to identify the proper entry point to insert the IM rod. The statistical significance was calculated on the basis of a 5% level (P < 0.05) using the Student's t-test. RESULTS:: For the males, the average ideal entry point was 1.49 mm medial and 13.39 mm anterior to the AIN. The values were 1.77 mm medial and 15.29 mm anterior to the AIN in females. A significant difference was present between males and females (13.39 ± 2.46 mm vs. 15.29 ± 3.44 mm, t = 2.124, P = 0.040). When using the recommended location as the entry point for the IM rod, the mean potential error differed significantly from the femoral trochlear groove (the potential error of IM in males in coronal plane: 0.93° ± 0.24° vs. 1.27° ± 0.32°, t = -4.166, P <0.001; the potential error of IM in males in sagittal plane: 1.40° ± 0.42° vs. 2.79° ± 0.70°, t = 7.155, P < 0.001; the potential error of IM in females in coronal plane: 0.73° ± 0.28° vs. 1.15° ± 0.35°, t = 3.940, P < 0.001; and the potential error of IM in females in sagittal plane: 1.48° ± 0.47° vs. 2.76° ± 0.83°, t =5.574, P < 0.001). A significant difference was present between the recommended point and the point 10 mm anterior to the origin of the posterior cruciate ligament (the potential error of IM in males in coronal plane: 0.93° ± 0.24° vs. 1.53° ± 0.43°, t = 5.948, P < 0.001; the potential error of IM in males in sagittal plane: 1.40° ± 0.42° vs. 2.15° ± 0.75°, t = 3.152, P = 0.003; the potential error of IM in females in coronal plane: 0.73° ± 0.28° vs. 1.28° ± 0.42°, t = -4.632, P < 0.001; and the potential error of IM in females in sagittal plane: 1.48° ± 0.47° vs. 2.40° ± 0.93°, t = 3.763, P = 0.001). CONCLUSIONS: The technique described here is an innovative method for swift, easy, and accurate access to the medullary canal during TKA, and it can optimize the position and orientation of the prosthetic components in knee arthroplasty.

Extracorporeal Cardiopulmonary Resuscitation in Children of Asia Pacific: A Retrospective Analysis of Extracorporeal Life Support Organization Registry.

BACKGROUND: Recent advances in extracorporeal membrane oxygenation (ECMO) have led to increasing interest in its use during cardiopulmonary resuscitation (CPR). However, decisions regarding extracorporeal CPR (ECPR) in children are difficult as a result of limited studies, especially in Asia Pacific. The objective of this study was to investigate trends in survival and demographic details for children with ECPR in Asia Pacific recorded in the Extracorporeal Life Support Organization (ELSO) registry from 1999 to 2016 and identify the risk factors associated with in-hospital mortality. METHODS: The data of children younger than 18 years of age who received ECPR over the past 18 years in Asia Pacific were retrospectively analyzed. The data were extracted from the ELSO registry and divided into two 9-year groups (Group 1: 1999-2007 and Group 2: 2008-2016) to assess temporal changes using univariate analysis. Then, univariate and multiple logistic regression analyses were performed between survivors and nonsurvivors to identify factors independently associated with in-hospital mortality. RESULTS: A total of 321 children were included in final analysis, with an overall survival rate of 50.8%. Although survival rates were similar between Group 1 and Group 2 (43.1% vs. 52.5%, χ2 = 1.67, P = 0.196), the median age (1.7 [0.3, 19.2] months for Group 1 vs. 5.6 [0.8, 64.9] months for Group 2, t = -2.93, P = 0.003) and weight (3.7 [3.0, 11.5] kg for Group 1 vs. 6.0 [3.4, 20.3] kg for Group 2, t = -3.14, P = 0.002) of children increased over time, while the proportion of congenital heart disease (75.9% for Group 1 vs. 57.8% for Group 2, χ2 = 6.52, P = 0.011) and cardiogenic shock (36.2% for Group 1 vs. 7.2% for Group 2, χ2 = 36.59, P < 0.001) decreased. Patient conditions before ECMO were worse, while ECMO complications decreased across time periods, especially renal complications. Multiple logistic regression analysis of ECMO complications showed that disseminated intravascular coagulation (DIC), myocardial stunning, and neurological complications were independently associated with increased odds of hospital mortality. CONCLUSIONS: The broader indications and decreased complication rates make EPCR to be applicated more and more extensive in children in Asia Pacific region. ECMO complications such as myocardial stunning are independently associated with decreased survival.

A microfluidic chip-based co-culture of fibroblast-like synoviocytes with osteoblasts and osteoclasts to test bone erosion and drug evaluation.

Targeting fibroblast-like synoviocyte (FLS) migration and invasion-mediated bone erosion is a promising clinical strategy for the treatment of rheumatoid arthritis (RA). Drug sensitivity testing is fundamental to this scheme. We designed a microfluidic chip-based, cell co-cultured platform to mimic RA FLS-mediated bone erosion and perform drug-sensitive assay. Human synovium SW982 cells were cultured in the central channel and migrated to flow through matrigel-coated side channels towards cell culture chamber where RANKL-stimulated osteoclastic RAW264.7 and osteogenic medium (OS)-stimulated bone marrow mesenchymal stem cells (BMSC) were cultured in the microfluidic chip device, mimicking FLS migration and invasion-mediated bone erosion in RA. These SW982 cells showed different migration potentials to osteoclasts and BMSC. The migration of SW982 cells with high expression of cadherin-11 was more potent when SW982 cells were connected with the co-culture of RAW264.7 and BMSC. Simultaneously, in the co-cultured chamber, tartrate-resistant acid phosphatase (TRAP) activity of RANKL-stimulated RAW264.7 cells was enhanced, but alkaline phosphatase (ALP) activity was decreased in comparison with mono-cultured chamber. Furthermore, it was confirmed that celastrol, a positive drug for the treatment of RA, inhibited SW982 cell migration as well as TRAP activity in the cell-cultured microfluidic chips. Thus, the migration and invasion to bone-related cells was reconstituted on the microfluidic model. It may provide an effective anti-RA drug screen model for targeting FLS migration-mediated bone erosion.

MiR-19a Affects Hepatocyte Autophagy via Regulating lncRNA NBR2 and AMPK/PPARα in D-GalN/Lipopolysaccharide-Stimulated Hepatocytes.

This study aims to evaluate the potential involvement and regulatory mechanism of miR-19a in hepatocytes autophagy of acute liver failure (ALF). The in vitro hepatocytes injury model of primary hepatocyte and hepatocytes line HL-7702 was established by D-galactosamine (D-GalN) and lipopolysaccharide (LPS) co-treatment. Relative expression level of miR-19a and NBR2 was determined by qRT-PCR. Protein expression of AMPK/PPARα and autophagy-related gene was determined by Western blot. In hepatic tissue of 20 ALF patients and D-GalN/LPS-stimulated hepatocytes, miR-19a was upregulated and NBR2 was downregulated. D-GalN/LPS stimulation caused the inactivation of AMPK/PPARα signaling and the decrease of autophagy-related LC3-II/LC3-I ratio and beclin-1 expression in hepatocytes. The expression of both AMPK/PPARα and NBR2 were negatively controlled by miR-19a overexpression or knockdown. Moreover, both NBR2 and PPARα were targeted regulated by miR-19a according to luciferase reporter assay. In D-GalN/LPS-stimulated hepatocytes, AMPK activation promoted PPARα expression. AMPK inactivation inhibited the pro-autophagy effect of miR-19a and caused the decrease of LC3-II/LC3-I ratio and beclin-1 expression. PPARα activation abrogated the anti-autophagy effect of miR-19a mimic and caused the increase of LC3-II/LC3-I ratio and beclin-1 expression. NBR2 knockdown reversed the anti-autophagy impact of miR-19a inhibitor and caused the decrease of LC3-II/LC3-I ratio and beclin-1 expression. In summary, our data suggested that miR-19a negatively controlled the autophagy of hepatocytes attenuated in D-GalN/LPS-stimulated hepatocytes via regulating NBR2 and AMPK/PPARα signaling. J. Cell. Biochem. 119: 358-365, 2018. © 2017 Wiley Periodicals, Inc.

Local Administration of Bisphosphonate-soaked Hydroxyapatite for the Treatment of Osteonecrosis of the Femoral Head in Rabbit.

BACKGROUND: Systemic administration of bisphosphonates has shown promising results in the treatment of osteonecrosis of the femoral head (ONFH). However, few studies have evaluated the efficacy of local zoledronate (ZOL) administration in the treatment of ONFH. The purpose of this study was to investigate whether local administration of bisphosphonate-soaked hydroxyapatite (HA) could improve bone healing in an experimental rabbit model of ONFH. METHODS: This experimental study was conducted between October 2014 and June 2015. Forty-five rabbits underwent simulated ONFH surgery. Immediately following surgery, they were divided into three groups: model (untreated, n = 15), HA (treated with HA alone, n = 15), and HA + ZOL (treated with HA soaked in a low-dose ZOL solution, n = 15). Histological, immunohistochemical, and quantitative analyses were performed to evaluate bone formation and resorption 2, 4, and 8 weeks after surgery. RESULTS: Gross bone matrix and hematopoietic tissue formation were observed in the HA + ZOL group 4 weeks after surgery. The immunohistochemical staining intensities for 5-bromodeoxyuridine, runt-related transcription factor 2, osteocalcin, osteopontin, and osteoprotegerin were significantly higher in the HA + ZOL group than that in the model (P < 0.001, P< 0.001, P< 0.001, P< 0.001, and P = 0.018, respectively) and HA groups (P = 0.003, P = 0.049, P< 0.001, P = 0.020, and P = 0.019, respectively), whereas receptor activator of the nuclear factor-κB ligand staining intensity was significantly lower in the HA + ZOL group than that in the model and HA groups (P = 0.029 and P = 0.015, respectively) 4 weeks after surgery. No significant differences in bone formation or bone resorption marker expression were found between the three groups 2 or 8 weeks after surgery (P > 0.05). CONCLUSIONS: Local administration of HA soaked in a low-dose ZOL solution increased new bone formation while inhibiting bone resorption in an animal model of ONFH, which might provide new evidence for joint-preserving surgery in the treatment of ONFH.

[Study on medical pattern of traditional Chinese medicine and western medicine diagnosis and treatment of hypertension patients in 30 034 cases in real world].

Select patients diagnosed of hypertension in the first place in 16 hospitals and the patients were described by association rules analysis and distribution for the analysis in the study,in order to understand the information of diagnosis and treatment in hypertension patients in real world. The information include age, gender, admission condition, inpatient department, hospitalization expenses, western medicine comorbidities, the traditional Chinese medicine (TCM) syndrome and the medicine. The average age of patients was 64 years in the study. The proportion of men to women about 1. 10: 1. Admission condition is critical for about 10.12% of the total and more concentrated in the cardiovascular department. Hospital stay ranged from 8 to 14 d. Inpatients with medical insurance is 62.93%. Total hospitalization cost distribution most is the 5 000-10 000 RMB. Hypertension complicated with coronary heart disease, blood lipoprotein disorder disease; phlegm and blood stasis and Yin deficiency of liver and kidney are the most in TCM syndrome type. Promoting blood circulation and removing blood stasis is the major in Chinese medicine treatment. Western medicine treatment basically conforms to the guidelines. The most antihypertensive drugs is calcium antagonistst, accounting for about 81.2% of the total number. Class ACEI, class ARB, beta blockers, diuretics class are accounted for 43.0%, 43.4%, 42.4%, 42.4%, fixed compound is only 2 393, accounting for about 8%. the total frequency of five classes of antihypertensive drugs is 78 206 times. The principal conclusions of this analysis are as follows: the elderly people is the most in hypertension, more men than women; medical insurance is the majority type in hospitalization cost; nearly half of the population is combined with coronary heart disease; phlegm and blood stasis and yin deficiency of liver and kidney are the most in TCM syndrome type; western medicine treatment basically conforms to the guidelines. Combination therapy is more, less fixed compound preparation in western medicine. Chinese medicine is mainly to promoting blood circulation. Suggesting that the clinical treatment in strict blood pressure and at the same time, pay attention to combination therapy and the use of fixed compound preparation,it's useful to control the blood pressure better. Combined with traditional Chinese medicine and resolving phlegm and removing blood stasis, reduce the target organ damage, reduce complications, the prevention and control work of hypertension in China still faces enormous challenges at present. The result provides reference information for clinical medicine and medical research.

Effect of carbodiimide cross-linking of decellularized porcine pulmonary artery valvular leaflets.

Decellularization provides low immunogenicity and is only slightly subject to calcification in tissue engineering. However, the mechanical properties of the tissues are weakened after decellularization. We adopted cross-linking agent 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) to treat decellularized porcine pulmonary artery valvular leaflets to improve their mechanical properties. Twenty porcine pulmonary artery valvular leaflets were divided into three groups: the fresh control group A, group B treated with trypsin and Triton X-100 to remove cells, and group C cross-linked with EDC after decellularization. All samples were evaluated the physical and mechanical properties and were then subcutaneously embedded in rabbits. These valvular leaflets were removed after 1, 2, or 4 weeks and checked for pathological changes. The cells of the valvular leaflets were completely removed. The thickness of the valvular leaflets was thinner in group B than in group A (P<0.01). In the subcutaneous embedding of the group B samples, there was mild immunological response after 1-2 weeks, and parts of the scaffolds were degraded. After 4 weeks, fibroblasts had grown into the scaffolds. In group C, there was an increase in the tensile strength and thermal shrinkage temperature in group C compared with group B (P<0.01). In subcutaneous embedding of the group C samples, there was a mild immunological response after 1-2 weeks. The fibroblasts had grown into the samples. The EDC-based cross-linking procedure can enhance the tensile strength of decellularized pulmonary artery valvular leaflets and both decrease the valvular leaflets' rejection and promote tissue regeneration in vivo.

Decellularized porcine pulmonary arteries cross-linked by carbodiimide.

The physical properties of the tissues are weakened after decellularization, and the exposed collagen fibers are prone to thrombogenesis. Several studies have proven that the use of carbodiimide (EDC) as a cross-linking agent can improve the properties of decellularized xenogeneic scaffold materials. We adopted EDC for the treatment of porcine pulmonary arteries in an effort to improve the physical properties of these arteries following decellularization. Twenty porcine pulmonary arteries were randomly divided into 3 groups. The control group (group A) consisted of fresh porcine pulmonary arteries with no further processing; group B was treated with trypsin and the detergent Triton X-100 to remove cells; and group C was cross-linked with EDC after trypsin and Triton X-100 treatment, as in group B. The pulmonary arteries were assessed based on water content, thickness, tensile strength, and thermal shrinkage temperature, to evaluate the physical properties of all of the samples. The scaffolds were then subcutaneously embedded in rabbits. These constructs were removed after 4 weeks and checked. The cells and matrix components of the arterial walls were removed and the fibrous scaffolds were retained. In group B, the moisture content of the pulmonary arterial walls was increased; and the thickness of the walls and the tensile strength of the pulmonary arteries were decreased in comparison with group A. In subcutaneous embedding of the group B samples in rabbits, after 4 weeks, fibroblasts had grown into the scaffolds and regenerated the tissue. The water content was decreased in the pulmonary arterial walls, there was an increase in the tensile strength and the thermal shrinkage temperature in group C compared with group B. The EDC-based cross-linking procedure can enhance the tensile strength of decellularized pulmonary arteries and decrease scaffold rejection and degradation and promote tissue regeneration in vivo.

Abdominal wall desmoid tumors: A case report.

Desmoid tumors (DTs) are rare lesions that do not possess any metastatic potential. However, they have a strong tendency to invade locally and recur. They constitute 3% of all soft tissue tumors and 0.03% of all neoplasms. Abdominal DTs occur sporadically or are associated with certain familial syndromes, such as familial adenomatous polyposis (FAP). The single form of this neoplasm most frequently occurs in females of reproductive age and during pregnancy. A female patient with a DT of the abdominal wall who had no relevant family history was admitted to hospital. The patient, who presented with a painless mass in the left anterolateral abdomen, had no history of trauma, surgery or childbearing. According to the medical history, physical examination and CT report, the patient was diagnosed with DT. Radical resection of the affected abdominal wall musculature was performed, and the defect was replaced with a polypropylene mesh. The histological diagnosis was of DT. The patient remains in good health and complete remission without any other treatment following surgery. DTs exhibit aggressive growth and have a high rate of recurrence. Surgery is the optimal treatment, and subsequent radiotherapy may decrease the local recurrence rate. Further research into their aetiology is required combined with multicentre clinical trials of new treatments in order to improve management of this disease. This case report provides general knowledge of DT, and may be used as a guidance for diagnosis and treatment.

Effect of enhanced expression of COL8A1 on lymphatic metastasis of hepatocellular carcinoma in mice.

The present study aimed to investigate the influence of COL8A1 expression on cell invasiveness, drug sensitivity and tumorigenicity of hepatocellular carcinoma Hepa1-6 cells with low metastatic potential. COL8A1-1-pEGFP-N2 and pEGFP-N2 were transfected into experimental and control group cells. The COL8A1 expression in transfected Hepa1-6 cells was analyzed with RT-PCR and western blot analysis. The invasive potential of transfected Hepa1-6 cells was tested in invasion experiments in vitro and the tumorigenic ability of the transfected Hepa1-6 cells was tested in mouse tumors in vivo. Hepa1-6 cell proliferation and D-limonene sensitivity was analyzed using the MTT method. Expression of COL8A1 in the Hepa1-6/COL8A1 group showed a significant increase when compared with the untransfected cells of the Hepa1-6 control group and empty-plasmid transfected cells from the Hepa1-6/mock control group. Enhanced COL8A1 expression increased cell proliferation and matrix adhesion ability via invasion and tumorigenesis in vivo while the sensitivity to D-limonene was concurrently inhibited. The expression of COL8A1 in hepatocarcinoma cells was correlated with increased tumor cell proliferation, invasion, in vivo tumorigenicity and reduced antitumor drug sensitivity, and may provide novel targets for tumor therapy.