ObjectiveTo construct a transgenic cell sheet of cartilage-derived morphogenetic protein 1 (CDMP-1) by adenovirus vector in vitro and to identify its biological activity. MethodsThe bone mesenchymal stem cells (BMSCs) were isolated from bone marrow of 1-month-old rabbit, and cultured in vitro. The 3rd-6th generation of BMSCs were used for experiment. The experiment was divided into 3 groups:BMSCs transfected by adenovirus (Ad)-cytomegalovirus (CMV)-human CDMP1 (hCDMP1)-internal ribosome entry site (IRES)-enhanced green fluorescent protein (EGFP) in group A, BMSCs transfected by Ad-CMV-EGFP in group B, and untransfected BMSCs in group C. The expression of green fluorescence was observed in 3 groups under fluorescent inverted microscope. MTT assay was used to detect the proliferation of the cells. The cell sheet was obtained by means of temperature-responsive culture dish for 14 days. The morphological and HE staining observations of the cell sheet were carried out. RT-PCR and Western blot were used to detect the expressions of hCDMP1 and collagen type II at gene and protein levels, while alcian blue staining was used to detect the expression of glycosaminoglycans (GAG). ResultsBright green fluorescence was observed in transfected cells at 72 hours under fluorescent inverted microscope, and the transfection efficiency was up to 90%. MTT assay showed approximate S-shaped growth curves in 3 groups, showing no significant difference in the absorbance (A) value among 3 groups within 9 days (P>0.05). The three-dimensional cell sheets were successfully harvested in vitro. The RT-PCR and Western blot showed that there were positive expressions of hCDMP1 and collagen type II in group A and negative expression in other 2 groups. HE staining and alcian blue staining showed that there were rich fibrous tissues, mass extracellular matrix, and dark blue metachromatic granules in group A, but there was less fibrous tissues and no specific blue metachromatic granules in other 2 groups; and the positive expression area was significantly lower and gray scale of GAG was significantly higher in group A than that in groups B and C (P<0.05). ConclusionA transgenic cell sheet of exogenous recombinant hCDMP1 by adenovirus vector can express collagen type II and GAG, so it has chondrogenic capacity. This technology that overcomes limitations in traditional tissue engineering, such as low cell-attachment efficiency and inflammatory reaction, may be a new tissue engineering approach for hard tissue reconstruction and is hopeful to build a large density of tissue engineered cartilage.
Objective To identify the prevalence and related factors of emotional disorder of inpatients in Department of Spinal Surgery . Methods A cross-sectional study was conducted from October 2015 to April 2016 to screen 300 patients undergoing spinal surgery. Huaxi Emotional-distress Index was used to assess the emotional status of the patients, and a self-designed general condition questionnaire was used to evaluate the demographic data. Results The prevalence of emotional disorder of patients in Department of Spinal Surgery was 14.3%. Anxiety was the main type of emotional disorder. Logistic regression analysis showed that the education level and pathogeny were the main factors of emotional disorder. Conclusions In Department of Spinal Surgery, the inpatients’ psychological status is poor, and anxiety is the main emotional disorder. Emotional disorder is related to education level and pathogeny. Timely psychological treatment should be used in order to comprehensively improve the level of recovery of the inpatients.
Objectives To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients. Methods A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared. Results Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05). Conclusions The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.
ObjectiveTo investigate the status of urination in post-spineoperative (cervical thoracic and lumber verteb) patients under the enhanced recovery after surgery (ERAS) mode.MethodsPatients who were admitted to the West China Hospital of Sichuan University from October 2018 to February 2019 were enrolled. The urination status of the patients was collected by using questionnaires. All patients were divided into normal urinating group, induced urinating group and catheterization group according to their urination status after returning to the ward.ResultsA total of 106 patients were included, including 78 (73.6%) who urinated smoothly [the first urinating time (72.18±36.33) min], 20 (18.9%) who urinated after induction [the first urinating time (81.50±41.68) min], and 8 (7.5%) who received catheters after induction failure [the first urinating time (162.50±84.52) min]. The different operation, operation time, position of urination, and postoperative pain degree affecting the placement of urethral catheter differed from each other significantly (P<0.05). Among the three groups, the differences were statistically significant in operation time, operation methods, position of urination (except for the induced urination group vs. catheterization group) and postoperative pain degree (except for the induced urination group vs. catheterization group) in pairs (P<0.05). There was no significant difference in other factors among three groups in pairs (P>0.05).ConclusionsMost post-spineoperative patients can autonomously urinate without catheter under the ERAS mode, which bases on operation methods, operation time, and the first urinating posture after the surgery. Early attention should be paid to patients with dysuresia to promote their early rehabilitation.