ObjectiveTo explore the effects of interleukin 10 (IL-10) gene modified bone marrow mesenchymal stem cells (BMSCs) on the expression of inflammatory cytokines and neuronal apoptosis in rats after cerebral ischemia reperfusion injury.MethodsBMSCs were cultured by whole bone marrow adherence screening method. The properties of BMSCs were identified by immunocytochemical methods. BMSCs at passage 3 were transfected with recombinant adenovirus IL-10 gene (AdIL-10-BMSCs). The model of middle cerebral artery occlusion was made in 40 adult male Sprague Dawley rats by thread embolism method. The rats were randomly divided into 4 groups (n=10). At 3 hours after modelling, the rats of groups A, B, C, and D received tail intravenous injection of 1 mL L-DMEM medium containing 10% FBS, 61.78 ng IL-10, 1 mL BMSCs suspension (2×106 cells/mL), and 1 mL AdIL-10-BMSCs cell suspension (2×106 cells/mL), respectively. The cells were labelled with BrdU before cell transplantation in groups C and D. At 7 days after reperfusion, the brain tissue was harvested to detect the expression of OX42 by immunohistochemical assay, to determine the concentration of tumor necrosis factor α (TNF-α) and IL-1β by ELISA, and to detect the apoptosis by TUNEL assay. BrdU labelled cells were observed by immunofluorescence staining in groups C and D.ResultsBrdU labelled positive cells with green fluorescence were observed in the brain tissue of groups C and D, which mainly distributed in the striatum, cerebral cortex, and subcortex around the infarction area. The number of OX42 positive cells was significantly less in groups B, C, and D than group A (P<0.05), and in group D than groups B and C (P<0.05). Compared with the other 3 groups, the contents of TNF-α and IL-1β significantly decreased in group D (P<0.05). TUNEL assay showed that the apoptotic cells (TUNEL positive cells) were mainly seen in the striatum and fronto parietal subcortical tissues (equivalent to ischemic penumbra). The number of TUNEL positive cells in group D was significantly less than that in groups A, B, and C (P<0.05).ConclusionAdIL-10-BMSCs can inhibit secretion of TNF-α and IL-1β from microglial cells and inhibit the nerve cell apoptosis around infarct brain tissue, which might contribute to its protective role upon cerebral ischemia reperfusion injury.
Objective To understand the current situation of ambulatory surgery cancellation rates and the reasons for cancellation. Methods China National Knowledge Infrastructure, Wanfang data, VIP database, Embase, Web of Science, PubMed and Cochrane Library were systematically searched for literature reporting cancellation of ambulatory surgery and published between January 1st, 2000 and September 1st, 2023. Data extraction and meta-analysis were conducted after literature screening, and subgroup analyses were conducted based on the type of the ward, reasons for cancellation, and study sites. Results A total of 19 studies were included, with a total of 270528 cases of ambulatory surgeries, among which 12250 cases were cancelled. The ambulatory surgery cancellation rate was 5.8% [95% confidence interval (CI) (4.5%, 7.1%)]. Subgroup analyses showed that the cancellation rates of general wards, pediatric wards, and ophthalmic wards were 4.0% [95%CI (2.9%, 5.1%)], 9.9% [95%CI (5.2%, 14.5%)], and 8.1% [95%CI (2.7%, 13.4%)], respectively, and the difference in the cancellation rate among different types of wards was statistically significant (P=0.02); there was a significant difference in the surgery cancellation rate among different reasons for cancellation (P<0.01), the highest cancellation rate of surgery was due to disease factors, which was 2.5% [95%CI (1.2%, 3.9%)]; there was no statistically significant difference in the cancellation rate among different study sites (P=0.43). Conclusions The issue of cancellation of ambulatory surgery is prominent in clinical practice. Optimized management is therefore suggested in urgent.
Objective To systematically review the CT characteristic differences between pulmonary cryptococcosis (PC) and lung cancer presenting as solitary nodules. Methods PubMed, Embase, Web of Science, Cochrane Library, Wanfang, China National Knowledge Infrastructure and SinoMed were searched to collect case-control studies of the patients with PC and lung cancer presenting as solitary nodules on CT. The search period was from databases establishment to December 2023. We conducted a meta-analysis on the included studies. Results A total of 7 studies were included, 342 PC patients, and 370 lung cancer patients. The meta-analysis results showed that compared with lung cancer, PC patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the lower lobe of the lung [odds ratio (OR)=1.91, 95% confidence interval (CI) (1.39, 2.62)], presence of bronchial inflation sign [OR=5.79, 95%CI (1.45, 23.21)], and halo sign [OR=6.64, 95%CI (2.87, 15.38)]. Compared with PC, lung cancer patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the upper lobe of the lung [OR=0.52, 95%CI (0.35, 0.78)], presence of lobulation sign [OR=0.15, 95%CI (0.08, 0.27)], spiculation sign [OR=0.48, 95%CI (0.35, 0.65)], pleural indentation sign [OR=0.15, 95%CI (0.04, 0.50)], and vascular bundle sign [OR=0.20, 95%CI (0.05, 0.77)]. There was no statistically significant difference in CT between PC patients and lung cancer patients in terms of lesion size, relationship with pleura, vacuolar sign, cavity, and whether the broad base was connected to pleura (P>0.05). Conclusions For CT showing solitary nodules, PC nodules are more likely to be distributed in the lower lobe of the lungs, with bronchial inflation sign and halo sign. Lung cancer nodules are more likely to be distributed in the upper lobe of the lungs, with lobulation sign, spiculation sign, pleural indentation sign and vascular bundle sign.
目的 探讨乳腺脂肪肉瘤的临床病理特点及鉴别诊断。 方法 分析2010年3月收治的1例乳腺多形性脂肪肉瘤的临床表现、组织病理学特征及免疫表型特点，并复习相关文献。 结果 肿瘤由高级别多形性肉瘤和数量不等的多形性脂肪母细胞组成。免疫组织化学：肿瘤细胞呈S-100蛋白阳性表达、CD34灶性阳性表达，细胞角蛋白、上皮膜抗原、巨噬细胞表面抗原、结蛋白、平滑肌肌动蛋白、肌调节蛋白、肌浆蛋白、CD31均呈阴性表达。结论 乳腺脂肪肉瘤是一种少见的原发于乳腺的间叶源性肿瘤，诊断上应首先排除乳腺化生性癌和恶性叶状肿瘤伴脂肪肉瘤分化，应依据形态学特点和免疫组织化学结果进行鉴别。
Objective To explore the effect of lean management on patients’ safety, medical quality, and satisfaction in day surgery ward. Methods The patients underwent day surgery between May 4th, 2017 and April 30th, 2018 were selected as the subjects (the lean management of day surgery ward implemented on November 1st, 2017). The patients underwent day surgery between May 4th and October 31st, 2017 were taken as the control group (n=2 864), and the ones between November 1st, 2017 to April 30th, 2018 were taken as the observation group (n=2 705). The following data between the two groups were compared: the cancellation rate of day surgery, the 24-hour delayed discharge rate, the rate of 12-hour median or severe pain after surgery, the rate of 12-hour postoperative nausea and vomiting, the awareness rate of health education, the patients’ satisfaction, and the incidence of adverse events.Results Compared with those in the control group, the cancellation rate of surgery (4.81% vs. 6.25%), the 24-hour delayed discharge rate (2.76% vs. 4.28%), the 12-hour median or severe pain after surgery (5.55% vs. 8.31%), the rate of 12-hour postoperative nausea and vomiting (5.86% vs. 7.71%) decreased in the observation group, and the differences were statistically significant (P<0.05). The awareness rate of health education increased from 92.18% to 98.02% after the implementation of lean management, the patients’ satisfaction increased from 92.48±2.58 to 96.53±1.64 after the implementation of lean management, and the differences were statistically significant (P<0.05). The incidences of adverse events in the two groups were not statistically different (0.16% vs. 0.41%, P>0.05). Conclusion The implementation of lean management model can insure the medical safety and quality of day surgery, and improve overall work efficiency and the patients’ medical service experience in day surgery ward.
ObjectiveTo explore and analyze the current situation of discharge readiness and delayed discharge for patients undergoing ambulatory thyroid malignancy surgery.MethodsBy convenient sampling, 284 thyroid malignancy patients who were admitted to the day surgery ward of Xiangya Hospital, Central South University from September 1st to December 30th, 2018 were selected as the research objects. The general information questionnaire and Readiness for Hospital Discharge Scale (RHDS) were used as the research tools. Descriptive statistical analysis was used to analyze the demographic statistics of the patients, and the differences of different dimension scores and total scores of RHDS were analyzed based on the basic information of patients.ResultsThe total score of RHDS was 8.66±0.60 for patients, including 6.31±0.74 for dimension of physical condition, 9.49±0.87 for dimension of disease knowledge, 9.20±0.99 for dimension of coping ability after discharge, and 9.63±0.74 for dimension of expected social support. The delayed discharge rate was 2.1%. There was no significant difference in the scores of different dimensions or total scores in RHDS of patients undergoing ambulatory thyroid malignancy surgery with different gender, age, education level or whether there was a special person to take care of them (P>0.05). There were differences between patients with delayed discharge and the ones without delayed discharge in the three dimensions namely physical condition, disease knowledge, and coping ability, as well as the total scores (P<0.05), while there was no statistically significant difference in the scores of expected social support dimension (P>0.05).ConclusionsThe discharge readiness for patients undergoing ambulatory thyroid malignancy surgery is good. The medical staff should provide health intervention measures according to the specific situation of patients, so as to improve the quality of discharge guidance, and ensure the safety of patients.
ObjectiveTo break through the key problem in the process of ambulatory surgery operation and management, improve the operational efficiency of hospital, and ensure the quality and safety of medical care through new established ambulatory surgery informative platform.MethodsThrough the analysis of medical requirements and process optimization in ambulatory surgery in Xiangya Hospital, Central South University from March to April, 2020, we constructed an ambulatory surgery informative platform centered on patient behavior tracking.ResultsThere wasa significant difference in the reception time of different appointment modes before and after the launch of information platform [(290.45±50.35) vs. (158.58±40.27) s; t=16.040, P<0.001]. After the platform system went online, patients’ satisfaction with the treatment process, appointment waiting time, and overall satisfaction were higher than before (P<0.05); there was no significant difference in patients’ attitude towards medical staff before and after the system went online (P>0.05). The results of medical staff’s work experience after the system went online showed that the use of information platform could make the work more efficient (91.09%), the process more reasonable (91.09%), accurately and timely grasp the patient’s information (95.05%), guarantee the medical quality and safety (96.04%), and reduce the medical cost (88.12%).ConclusionThe ambulatory surgery informative platform improved our work efficiency and patients’ satisfaction, assured the quality and safety of medical care, and strengthen the multi-disciplinary synergy at the same time.
Objective To analyze the causes for day surgery cancellations before admission or on the same day of operation, and put forward targeted measures to improve the medical resource utilization and patient satisfaction. Methods The basic information and clinical data of patients who had been scheduled for surgery in the Day Surgery Center of West China Hospital, Sichuan University between January 2018 and September 2021 were collected. The reasons for the surgery cancellations before admission or on the same day of operation were analyzed. Results From January 2018 to September 2021, a total of 45176 patients were successfully scheduled for day surgery, and 44300 patients completed surgery as planned. A total of 876 operations (1.94%) were cancelled after being scheduled, including 546 (1.21%) before admission and 330 (0.73%) on the surgery day. Ranked from high to low according to the cancellation rates, the top five departments were Department of Dermatology, Department of Vascular Surgery, Department of Hepatobiliary Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, and Department of Gastroenterology, with a cancellation rate of 3.38% (8/237), 2.90% (25/863), 2.85% (101/3548), 2.48% (171/6893), and 1.91% (260/13578), respectively. In the reasons for cancellations, patient factors accounted for 57.31% (502/876) and medical management factors accounted for 42.69% (374/876). Conclusions The cancellations of day surgery mainly occur before admission, and are mainly caused by patient factors. It is necessary to strengthen the preoperative education for day surgery patients, and enhance the communication and cooperation between surgery physicians, nurses and technicians, in order to reduce the operation cancellation rate and make reasonable and efficient use of medical resources.
目的 研究细胞视黄酸结合蛋白（CRABP）Ⅱ、表皮型脂肪酸结合蛋白（E-FABP）和Ki-67在乳腺浸润性导管癌中的表达情况及三者的相关性。 方法 采用免疫组织化学检测2001年1月－2007年12月手术切除的152例乳腺浸润性导管癌中CRABPⅡ、E-FABP和Ki-67的表达。 结果 在浸润性导管癌中，CRABPⅡ在Ki-67阴性组的阳性率高于Ki-67阳性组（P＜0.05），相反地，E-FABP在Ki-67阳性组的阳性率高于Ki-67阴性组（P＜0.05）。CRABPⅡ和Ki-67表达呈负相关（rS=?0.432，P＜0.05）；E-FABP和Ki-67表达呈正相关（rS=0.842， P＜0.05）。E-FABP和Ki-67的表达具有协同性，E-FABP和Ki-67共同表达与肿瘤的转移有关（P＜0.05）。单因素生存分析显示，E-FABP的阳性表达患者、Ki-67的阳性表达患者以及E-FABP和Ki-67的共同阳性表达患者的预后差（P＜0.05）。多因素生存分析提示E-FABP的表达（RR=4.223，P=0.012）和TNM分期（RR=8.412，P=0.000）是影响浸润性导管癌患者预后的独立危险因素。 结论 在乳腺浸润性导管癌中，CRABPⅡ和E-FABP与肿瘤细胞的增殖有关，CRABPⅡ抑制细胞增殖，E-FABP促进细胞增殖。E-FABP和Ki-67在浸润性导管癌的发生、发展中起协同作用，两者的阳性表达可能对评估肿瘤的转移和患者的预后有一定价值。
Objective To investigate the role of AKT/FOXOs /atrogin-1/MuRF1 signaling pathway in skeletal muscle atrophy in rats with chronic obstructive pulmonary diseases( COPD) .Methods Passive cigarette smoking was used to establish COPD model. The protein expression of atrogin-1, MuRF1, FOXO-1, phosohorylated-AKT and total AKT were measured by Western blot. The mRNA expression of atrogin-1, MuRF1 and FOXO-1 were measured by reverse transcription-polymerase chain reaction( RT-PCR) . Results Compared with the control group, the mRNA expressions of atrogin-1, MuRF1 and FOXO-1 significantly increased in extensor digitorum longus ( EDL) of the COPD group (Plt;0.05 ) . Meanwhile the protein expression of atrogin-1 and MuRF1 significantly increased in the COPD group(Plt;0.05) , while the protein expression of FOXO-1 was not significantly different between two groups(Pgt;0.05) . In addition, , the protein expression of phosohorylated-AKTand the ratio of phosohorylated-AKT to total AKT significantly increased in EDL of the COPD group(Plt;0.05) . Conclusion The mRNA and protein expression of AKT/FOXOs/ atrogin-1 /MuRF1 in skeletal muscle are significantly increased in COPD rats, suggesting that AKT/FOXOs/ atrogin-1 /MuRF1 signalling pathway plays a crucial role in skeletal muscle atrophy of COPD.