ObjectiveTo explore the psychological pressure in Intensive Care Unit (ICU) nurses and the sources of their pressure. MethodWe investigated the ICU nurses in West China Hospital with a self-designed psychological pressure questionnaire from March to September 2013. ResultsThe total stress level of ICU nurses was 2.89±0.86. The top five sources were low salaries and welfare benefits (3.37±0.61), high frequency of night work (3.31±0.88), wide need of knowledge (3.22±0.41), heavy workload (3.20±0.80) and chronic fatigue syndrome (3.19±0.75). ConclusionsGreat psychological pressure exists in ICU nurses. We urgently need effective approaches to relieve the stress of ICU nurses in order to improve the efficiency and quality of nursing service.
ObjectiveTo review the research progress of novel cross-linking methods applied in bio-derived materials. MethodsThe literature about the latest progress in the cross-linking methods of bio-derived materials was reviewed and analyzed. ResultsThe novel cross-linking methods of the bio-derived materials can be divided into chemical methods, physical methods, and biological methods, whose available application and cross-linking properties are greatly depended on their mechanisms. So proper methods should be developed to meet the various application requirements of the materials. A series of studies shows the feasibility and availability of the cross-linked bio-derived materials in the repair and reconstruction of the tissue. ConclusionBio-derived materials modified by novel cross-linking methods are proved to obtain excellent biocompatibility and tissue repair ability, better mechanical properties and degradation properties, and so on. Those methods provide researchers more choices to cross-linking materials, which are help to obtain the clinical tissue engineering products.
ObjectiveTo prepare the small intestinal submucosa (SIS)-silk composite scaffold for anterior cruciate ligament (ACL) reconstruction, and to evaluate its properties of biomechanics, biocompatibility, and the influence on synovial fluid leaking into tibia tunnel so as to provide a better choice in the clinical application of ACL reconstruction. MethodsThe silk was used to remove sericin and then weaved as silk scaffold, which was surrounded cylindrically by SIS to prepare a composite scaffold. The property of biomechanics was evaluated by biomechanical testing system. The cell biocompatibility of scaffolds was evaluated by live/dead staining and the cell counting kit 8 (CCK- 8). Thirty 6-week-old Sprague Dawley rats were randomly assigned to 2 groups (n=15). The silk scaffold (S group) and composite scaffold (SS group) were subcutaneously implanted. At 2, 4, and 8 weeks after implanted, the specimen were harvested for HE staining to observe the biocompatibility. Another 20 28-week-old New Zealand white rabbits were randomly assigned to the S group and SS group (n=20), and the silk scaffold and composite scaffold were used for ACL reconstruction respectively in 2 groups. Furthermore, a bone window was made on the tibia tunnel. At last, the electric resistance of tendon graft in the bone window was measured and recorded at different time points after 5 mL of 10% NaCl or 5 mL of ink solution was irrigated into the joint cavity recspectively. ResultsThe gross observation showed that the composite scaffold consisted of the helical silk bundle inside which was surrounded by SIS. The maximal load of silk scaffold and composite scaffold was respectively (138.62±11.41) N and (137.05±16.95) N, showing no significant difference (P>0.05); the stiffness was respectively (24.65±2.62) N/mm and (24.21±2.39) N/mm, showing no significant difference (P>0.05). The live/dead staining showed that the cells had good activity on both scaffolds. However, the cells on the composite scaffold had better extensibility. In addition, the cell proliferation curve indicated that no significant difference in the absorbance (A) values was founded between groups at various time points (P>0.05). HE staining showed less inflammatory cells and much more angiogenesis in SS group than in S group at 2, 4, and 8 weeks after subcutaneously implanted (P<0.05), indicating good biocompatibility. Additionally, the starting time points of electric resistance decrease and the ink leakage were both significantly later in SS group than in S group (P<0.05). The duration of ink leakage was significantly longer in SS group than in S group (P<0.05). ConclusionThe SIS-silk composite scaffold has excellent biomechanical properties and biocompatibility and early vacularization after in vivo implantation. Moreover, it can reducing the leakage of synovial fluid into tibia tunnel at the early stage of ACL reconstruction. So it is promising to be an ideal ACL scaffold.
ObjectiveTo systematically evaluate the association between eNOS gene a/b polymorphism and diabetic retinopathy susceptibility. MethodsPubMed, EMbase, The Cochrane Library (Issue 5, 2015), CBM, CNKI, VIP and WanFang Data were systemically searched from inception to May 2015, to collect case-control studies about the eNOS a/b polymorphism and diabetic retinopathy susceptibility. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software. ResultsA total of 16 case-control studies were included, which involved 3 232 diabetic retinopathy cases and 3 555 controls. The results of meta-analysis showed that, in the total analysis, the a/b polymorphism of the eNOS gene was not associated with diabetic retinopathy risk (dominant model:OR=0.94, 95%CI 0.78 to 1.15, P=0.57; recessive model:OR=0.97, 95%CI 0.78 to 1.22, P=0.88; aa vs. bb:OR=0.89, 95%CI 0.71 to 1.12, P=0.32; ab vs. bb:OR=0. 94, 95%CI 0.77 to 1.14, P=0.52; a vs. b:OR=0.97, 95%CI 0.82 to 1.14, P=0.70); In the subgroup analysis by ethnicity, the a/b polymorphism was significantly associated with the risk of diabetic retinopathy in Africans, but not in Asians and Caucasians. ConclusionThe a/b polymorphism in the eNOS gene may be a risk factor of diabetic retinopathy in Africans.
Objective To summarize the development of process and clinical practice for radiomics. Methods Relevant literatures about the development of process and clinical practice of radiomics were collected to make a review. Results Radiomics, which resulting from big data, had been used in diagnosis, assessment of prognosis, and predictionof therapy response for neoplasm. Conclusion Radiomics is an important part of precision medical imaging in the eraof big data.
ObjectiveTo prepare polyurethane (PU) microspheres and evaluate its physicochemical properties and biocompatibility for biomedical applications in vitro. MethodsThe PU microspheres were prepared by self-emulsification procedure at the emulsification rates of 1 000, 2 000, 3 000, and 4 000 r/min. The molecular structure was tested by Fourier transform infrared spectrometer and the surface and interior morphology of PU microspheres were observed by scanning electron microscopy (SEM). PU microspheres prepared at best emulsification rate were selected for the subsequent experiment. The human umbilical vein endothelial cells (HUVECs) were cultured and seeded on the materials, then cell morphology and adhesion status were observed by calcein-acetoxymethylester/pyridine iodide (Calcein-AM/PI) staining. The cells were cultured in the H-DMEM containing 10%FBS with additional 1% phenol (group A), in the extracts of PU prepared according to GB/T 16886.12 standard (group B), and in H-DMEM containing 10%FBS (group C), respectively. Cell counting kit 8 (CCK-8) assay was used to detect the cell viability. The blood compatibility experiments were used to evaluate the blood compatibility, the PU extracts as experimental group, stroke-physiological saline solution as negative control group, and distilled water as positive control group. The hemolytic rate was calculated. ResultsThe SEM results of PU microspheres at the emulsification rate of 2 000 r/min showed better morphology and size. The microstructure of the PU was rough on the surface and porous inside. The Calcein-AM/PI staining showed that the HUVECs attached to the PU tightly and nearly all cells were stained by green. CCK-8 assays demonstrated that group B and group C presented a significantly higher cell proliferative activity than group A (P<0.05), indicating low cytotoxicity of the PU. The absorbance value was 0.864±0.002 in positive control group and was 0.015±0.001 in negative control group. The hemolysis rate of the PU extracts was 0.39%±0.07% (<5%), indicating no hemolysis. ConclusionThe PU microspheres are successfully prepared by self-emulsification. The scaffold can obviously promote cell attachments and proliferation and shows low cytotoxicity and favorable blood compatibility, so it might be an ideal filler for soft tissue.
ObjectiveTo study the present situation of hospital orthopedic surgery incision infection, in order to provide the basis for further intervention. MethodsProspective investigation combined with retrospective investigation method was adopted in our study to perform a statistical analysis on orthopedic surgery incision infections among 545 patients in our hospital between January and December 2012. ResultsDuring the one year of follow-up, there were 10 cases of surgical incision infection among all the 545 patients, with an infection rate of 1.83%. The infection rate of class-Ⅰ incision was 0.46%, of class-Ⅱ was 5.13%, and of class-Ⅲ/Ⅳ was 12.12%, and the Cochrane-Armitage trend chi-square test showed significant trend among them (χ2=28.273, P<0.001). Based on different operation risk index, patients with index 1, 2, 3 had a surgical site infection rate of 0.82%, 2.60%, and 18.75%, respectively. The higher the index, the higher the surgery incision infection rate, and the trend was statistically significant (χ2=12.916, P<0.001). The infection rate was 1.43% for elective surgical procedures, and was 3.15% for emergency surgery, but there was no significant difference (P>0.05). ConclusionOrthopedic surgery has a high-risk surgical site infection rate, and incision classification and surgical risk index have statistical correlation with the incidence of hospital infection. In order to ensure the security of patients and reduce medical disputes, we should pay close attention to orthopedic surgery infection.
ObjectiveTo construct large block of engineered liver tissue by co-culture of fibroblasts and hepatocytes on collagen hydrogels in vitro and do in vivo implantation research. MethodsSilastic mould was prepared using three-dimensional printing technology. The collagen hydrogel scaffold was prepared by collagen hydrogel gel in the silicone mould and was removed. Sprague Dawley rat lung fibroblasts were co-cultured with primary hepatocytes at a ratio of 0.4:1 on the collagen hydrogel scaffold to construct large block of engineered liver tissue in vitro (group B), and primary hepatocytes cultured on the collagen hydrogel scaffold served as control group (group A). The cell morphology was observed, and the liver function was tested at 1, 3, 7, 14, and 21 days after culture. The rat model (n=24) of hepatic cirrhosis was made by subcutaneous injection of carbon tetrachloride. And in vivo implantation study was carried in cirrhosis rat model. The phenotypic characteristics and functional expression of hepatocytes were evaluated at 3, 7, 14, 21, and 28 days after implantation. ResultsIn vitro results indicated that hepatocytes in group B exhibited compact polyhedral cells with round nuclei and high expression of liver function. Moreover, cells aggregated to the most at 7 days. Album production and urea synthesis incresed significantly when compared with group A (P<0.05). In vivo results showed hepatocytes in group B survived for 28 days, and albumin production and urea synthesis were significantly increased. In addition, hepatocytes showed an aggregated distribution and cord-like structures, which was similar to normal liver tissue. ConclusionThe large block of engineered liver tissue constructed by co-cultured cells can form tissue similar to normal liver tissue in vivo, and survive for a long time, laying foundations for building more complete engineered liver tissue in the future.
ObjectiveTo systematically review the effect of dexamethasone in preventing post-operative nausea and vomiting (PONV) associated with epidural opioids for post-cesarean section analgesia. MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and CBM databases from inception to Dec. 31th 2015, to collect randomized controlled trials (RCTs) comparing dexamethasone with placebo/blank for the prevention of PONV associated with epidural opioids for postcesarean section analgesia. Two reviewer independently screened literature, extracted data, and assess the risk of bias of included studies. Then, meta-analysis was conducted by using RevMan 5.3 software. ResultsA total of 11 RCTs from 10 papers involving 1 011 patients were included. The results of meta-analysis showed that, compared with the placebo/ blank group, the dexamethasone group had lower incidence rates of post-operative nausea (RR=0.50, 95% CI 0.39 to 0.65, P < 0.000 01), postoperative vomiting (RR=0.39, 95% CI 0.29 to 0.52, P < 0.000 01), PONV (RR=0.37, 95% CI 0.30 to 0.46, P < 0.000 01), and rescue antiemetic (RR=0.34, 95% CI 0.19 to 0.62, P=0.000 5). ConclusionsCurrent evidence indicates that dexamethasone is effective for preventing PONV after epidural opioids for post-cesarean section analgesia. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
ObjectiveTo investigate the application of imbedding pancreaticojejunostomy in pure laparoscopic pancreaticoduodenectomy. MethodsEighty-five cases of laparoscopic pancreaticoduodenectomy in our hospital from May 2014 to December 2015 were analyzed retrospectively. According with inclusion criteria and exclusion criteria, 78 cases were investigated. They were divided into pancreatic duct-to-jejunum mucosa pancreaticojejunostomy group as controlled group (n=42) and imbedding pancreaticojejunostomy (technique of duct-to-mucosa PJ with transpancreatic interlocking mattress sutures) group as modified group (n=36). The rates of pancreatic fistula, abdominal infection/abscess, bile leakage, delayed gastric emptying, gastrointestinal/intraabdominal hemorrhage, pulmonary infection, and incision infection were investigated as well as hospital stays and pancreaticojejunostomy time in two groups were compared. ResultsThe rate of pancreatic fistula especially B to C grade pancreatic fistula in the modified group was obviously lower compared with which in the controlled group (8.3% vs. 31.0%, P < 0.05), pancreaticojejunostomy time ofmodified group was significantly shortened [(35.6±12.4) min vs. (52.8±24.6) min, P < 0.05] and total operative time also shortened [(322.4±23.6) min vs. (384.2±30.2) min, P < 0.05). There were no significant difference of the rates of abdominal infection/abscess, bile leakage, delayed gastric emptying, gastrointestinal/intraabdominal hemorrhage, pulmonary infection, ?incision infection, and hospital stays (P > 0.05)]. Conciusions The type of pancreaticojejunostomy has a significant impact on the rate of pancreatic fistula after laparoscopic pancreaticoduodenectomy. Imbedding pancreaticojejunostomy can decrease the rate of pancreatic fistula after operation, and shorten the pancreaticojejunostomy time and total operative time.