ObjectiveTo summarize the recent research progress of circRNA in gastric cancer, and to explore the clinical value of circRNA as new therapeutic target and diagnostic or prognostic biomarker for gastric cancer.MethodThe studies on circRNA and related literatures in gastric cancer were reviewed.ResultsAs a new member of the non-coding RNA family, circRNA played a key role in regulating the proliferation, invasion, migration, apoptosis, and therapeutic resistance of gastric cancer cells. At the same time, based on the stability and tissue-specific characteristics, circRNA possessed great potential as biomarker for early diagnosis or prognosis evaluation of gastric cancer.ConclusionscircRNA plays an important role in the initiation and progression of gastric cancer. As a diagnostic and prognostic biomarker and a new therapeutic target for gastric cancer, circRNA has great potential for clinical transformation.
Objective To elucidate the new concept and theory of neurorestoratology. Methods With the review of the development course and important research works in the field of neurorestoratology during the 20th century, especially recent 30 years, the regularity summary, science and technology philosophy induction, and theory distillation were carried out in this article. Results The new discipl ine system was brought forward as follows: ① Definition: neurorestoratology was asub-discipl ine of neuroscience which studies neural regeneration, neural structural repair of replacement, eruroplasticity and neuromodulation. The core purpose was to promote neural functional recovery of all neural degenerative diseases and damages. ② One central task and two basic points: to recover neurological function was the central research task all the time and the two basic points were the precl inical (basic) neurorestoration and the cl inical neurorestoration. ③ Four rationale of the discipl ine: l imited renovation, relearning, insufficient reserve, and l ifelong reinforcement. ④ Five major factors of neurorestoratology (5N’s dogma): neuroregeneration, neurorepair, neuroplasticity, neuromodulation, neurorehabil itation. “Neuroprotection” appeared to be included in the broad definition. ⑤ Four-step rule of neurorestoratology: structural neurorestoration, signal neurorestoration, rehabil itative neurorestoration, and functional neurorestoration. ⑥ Emphasize that translational medicine from lab to bed in neurorestoration. Conclusion The discipl ine of neurorestoratology has the vast development prospectand will be sure to increase the rapid progress of the basic and cl inical restorative neuroscience.
【摘要】 目的 探討胰腺癌早期診斷的要點及誤診因素。 方法 回顧性分析2009年7月8日收治的1例以腹脹、嘔吐為主要表現的胰腺癌患者。 結果 患者經及時剖腹探查確診為胰腺癌并行手術切除。 結論 胰腺癌起病隱匿，其早期誤診率高，進行胰腺癌的早期診斷、避免誤診是提高預后的重點和難點。【Abstract】 Objective To explore the main points of early diagnosis of pancreatic cancer and its misdiagnosis factors. Methods The clinical data of one patient with pancreatic cancer on the 8th July, 2009 was retrospectively analyzed. The chief complaints included abdominal distension and vomiting. Results By exploratory surgery in time,the patient was diagnosed as pancreatic cancer and underwent the resection. Conclusion The onset of pancreatic cancer is very insidious,usually with a high misdiagnosis rate. How to make the right early diagnosis and to avoid misdiagnosis are the focal points of improving the prognosis.
Objective To define a safe distance range from the LC-Ⅱ screw trajectory to the apex of the greater sciatic notch based on pelvic CT measurements, and to clinically assess the feasibility of using this range under iliac oblique view combined with iliac tangential view fluoroscopy to guide screw insertion. Methods CT scans of 104 normal pelvises collected between January 2022 and February 2025 were analyzed. There were 52 males and 52 females, with a median age of 45.8 years (range, 19-76 years). The RadiAnt DICOM Viewer software was used to reconstruct coronal, sagittal, and axial sections of the potential LC-Ⅱ screw trajectory. The maximum safety distance (Dmax) and the optimal safety distance (Dopt) from this trajectory to the greater sciatic notch were measured on the coronal and sagittal views. A retrospective analysis was conducted on 21 patients with LC-Ⅱ type pelvic fractures treated with the LC-Ⅱ screws fixation. And the screws were placed within the pre-defined safe distance under guidance from the iliac oblique view and iliac tangential view. Postoperative CT scans were obtained to evaluate the accuracy of screw placement. Results Radiographic measurements from the 104 cases showed that Dmax ranged from 1.87 to 3.87 cm (mean, 2.79 cm), and Dopt ranged from 1.01 to 2.92 cm (mean, 1.84 cm). Both Dmax and Dopt were significantly greater in the males than in the females (P>0.05). No significant difference was found between the left and right sides within the same gender (P>0.05). All 21 patients successfully underwent fracture reduction and fixation, with a total of 23 LC-Ⅱscrews implanted. According to the Lonstein grading system, the screw placement accuracy was rated as excellent in 16 screws, good in 3, fair in 3, and poor in 1, with an excellent and good rate of 82.6%. ConclusionUtilizing a CT-defined safe distance range from the screw trajectory to the greater sciatic notch, and adhering to this range under iliac oblique view combined with iliac tangential view fluoroscopy, enables the accurate and precise placement of LC-Ⅱ screws.
目的 總結老年糖尿病腎病（DN）連續性腎臟替代治療（CRRT）臨床護理措施。 方法 2010年2月－2012年3月對15例老年DN患者CRRT治療中，采取相應的通路與抗凝、飲食、并發癥及心理護理。 結果 患者經CRRT 治療82 h后水腫明顯消退，治療中發生5例低血糖，3例低血壓，3例高血壓，各種并發癥在相應的對癥處置和護理后很快緩解，且無感染病例。 結論 老年DN患者行CRRT治療中容易出現各種并發癥，護理人員需要采取相應的護理措施，確保治療順利進行及安全。
ObjectiveTo explore the application of different digestive system management strategies in the perioperative period of thoracolumbar fracture.MethodsThe clinical data of the patients with thoracolumbar fractures and pedicle screw fixation in Affiliated Hospital of Southwest Medical University from January 2016 to January 2018 were retrospectively analyzed. According to different perioperative management strategies of the digestive system, they were divided into two groups. Patients with careful management strategy were included in the observation group, and patients with routine management were included in the control group. The baseline conditions, the abnormalities of digestive tract function at admission and before and after surgery, the postoperative first feeding time, exhaust time, defecation time, the incidence of other postoperative complications except digestive tract complication, length of stay and patient satisfaction were compared between the two groups. At 6 months after surgery, the fracture healing, loosening or fracture of internal plants were compared between the two groups.ResultA total of 121 patients were included in the study, including 67 cases in the observation group and 54 cases in the control group. There was no significant differences in the baseline conditions between the two groups (P>0.05). There were no significant differences between the two groups in the incidences of digestive system dysfunction at admission (P>0.05). The incidences of digestive system dysfunction in the observation group before and after surgery were lower than those in the control group (29.9% vs. 53.7%, P<0.05; 35.8% vs. 61.1%, P<0.05). The first eating time [(3.7±1.1) vs. (6.7±2.6) h], exhaust time [(7.8±2.3) vs. (13.6±4.2) h], defecation time [(26.7±8.1) vs. (40.9±11.2) h] and length of stay [(6.5±2.4) vs. (9.0±2.7) d] in the observation group were shorter than those in the control group (P<0.005), and the patients’ satisfaction was better than that of the control group (8.3±1.1 vs. 7.6±1.3; t=?3.208, P=0.002). There was no statistically significant difference in the incidence of postoperative complications except digestive tract complication, and the fracture healing rate, the incidence of nail-rod breakage at6 months after surgery between the two groups (P>0.05). No internal plant loosening was found in the two groups of patients within 6 months after surgery.ConclusionThe application of the careful digestive system management strategy in patients with thoracolumbar fractures can help reduce the incidence of perioperative gastrointestinal dysfunction, promote the recovery of perioperative gastrointestinal function, shorten the length of hospital stay, and improve patient satisfaction.
ObjectiveTo evaluate the safety and efficacy of local sodium citrate anticoagulation for routine hemodialysis in high-risk patients with hemorrhage.MethodsA total of 150 patients who were admitted to West China Hospital from October 2018 to March 2019 for routine hemodialysis treatment with high-risk bleeding were selected as study objects. The patients were divided into without heparin anticoagulation group (group A) and with 4% sodium citrate anticoagulation group (group B) by random number table method, with 75 cases in each group. Biochemical indicators, serum calcium ion concentration, local anticoagulation safety index of citrate and dialysis adequacy index, blood coagulation in dialyzer and tube during dialysis wre observed in the two groups.ResultsThe coagulation events in group B were significantly lower than those in group A (Z=–4.889, P<0.001), and the urea clearance index in group B was higher than that in group A [(1.26±0.12) vs. (0.73±0.13) L/(min·1.73 m2); t=22.418, P<0.05]. There was a significant difference in the changes of urea nitrogen [(3.53±1.05) vs.(3.12±1.11) mmol/L; t=2.323, P=0.021] 24 hours after dialysis; other indicators showed no statistically significant difference (P>0.05). After the filter, serum calcium ion concentrations in group B at different time points were lower than those in group A [2 hours: (0.52±0.07) vs. (0.64±0.08) mmol/L; 4 hours: (0.56±0.09) vs.(0.63±0.09) mmol/L; t=5.198, 0.525, P<0.001], and the coagulation time was higher in group B than that in group A [2 hours: (172.56±14.78) vs. (151.45±19.81) s; 4 hours: (168.45±16.48) vs. (152.88±16.54) s; t=7.396, 5.775, P<0.001]. None of the patients had dialysis-related adverse events.ConclusionFour percent sodium citrate is effective and safe in anticoagulation therapy for hemodialysis patients, and it can reduce the risk of coagulation in dialyzer and ensure the adequacy of maintenance hemodialysis.
In the management of diabetic nephropathy patients with hemodialysis, diabetes link nurse (DLN) can realize the continuity of nursing management, simplify the communication between multiple disciplines, and play multiple roles such as relieving patients’ psychology, participating in scientific research and clinical management. In this paper, by introducing the origin and development status of DLN in foreign countries, and summarizing the function and clinical contribution of DLN in the management of diabetic nephropathy hemodialysis patients. This article combines the current development status of DLN in China, to arouse the attention of clinical nursing colleagues, and provide some reference for the management of diabetic nephropathy patients with hemodialysis and the training of DLN in China.
Previous studies have shown that growth arrest, dedifferentiation, and loss of original function occur in cells after multiple generations of culture, which are attributed to the lack of stress stimulation. To investigate the effects of multi-modal biomimetic stress (MMBS) on the biological function of human bladder smooth muscle cells (HBSMCs), a MMBS culture system was established to simulate the stress environment suffered by the bladder, and HBSMCs were loaded with different biomimetic stress for 24 h. Then, cell growth, proliferation and functional differentiation were detected. The results showed that MMBS promoted the growth and proliferation of HBSMCs, and 80 cm H2O pressure with 4% stretch stress were the most effective in promoting the growth and proliferation of HBSMCs and the expression level of α-smooth muscle actin and smooth muscle protein 22-α. These results suggest that the MMBS culture system will be beneficial in regulating the growth and functional differentiation of HBSMCs in the construction of tissue engineered bladder.
Abstract： Objective To explore the application of lower sternal incision with on-pump， beating heart intracardiac procedures in mitral valve replacement （MVR）. Methods We retrospectively analyzed clinical data of 42 patients （minimal incision group） with valvular heart diseases who underwent MVR via lower sternal incision under the beating heart condition in Xinqiao Hospital of the Third Military Medical University from January 2011 to December 2011. There were 16 male and 26 female patients with their average age of 42.3±12.7 years in the minimal incision group. We also randomly selected 42 patients with valvular heart diseases who underwent MVR via routine midline sternotomy during the same period in our department as the control group. There were 18 male and 24 female patients with their average age of 43.8±13.1 years in the control group. Operation time， cardiopulmonary bypass time， major complications， chest drainage in postoperative 24 hours， skin incision length and average postoperative hospital stay were observed and compared between the two groups. Results There was no major perioperative complication such as in-hospital death. There was no reexploration for postoperative bleeding， complete atrioventricular block， embolism or perivalvular leakage in the minimal incision group. There was no statistical difference in cardiopulmonary bypass time， operation time， or the incidence of reexploration for postoperative bleeding， wound infection and perivalvular leakage between the two groups（P＞0.05）. The skin incision length in the minimal incision group was shortened by 5.2 cm compared to that in the control group （7.9±1.4 cm vs. 13.1±3.3 cm， P=0.000）. Chest drainage in postoperative 24 hours in the minimal incision group was significantly less than that of the control group （183.6±40.2 ml vs. 273.4±59.9 ml， P=0.000）. Postoperative hospital stay in the minimal incision group was significantly shorter than that of the control group （8.1±1.3 d vs. 10.6±2.1 d， P=0.000）. Forty patients in the minimal incision group were followed up for 3-15 months and 2 patients were lost during follow-up. Four patients had postoperative wound pain， and the majority of patients didn’t have significant wound scar formation but a satisfactory quality of life. Thirty-eight patients in the control group were followed up for 3-15 months， 4 patients were lost during follow-up， and 17 patients had postoperative wound pain. Conclusion Lower sternal incision with beating heart can reduce the surgical injury， simplify the operation procedure and improve the therapeutic efficacy. It is a safe， effective and esthetic surgical approach for MVR.