ObjectiveTo explore the related factors and nursing countermeasures for psychonosema in postoperative laryngeal cancer patients. MethodsWe retrospectively analyzed the clinical data of eight patients who accepted laryngectomy and developed psychonosema from January 2008 to April 2013. The related factors for psychonosema in these patients were analyzed and nursing countermeasures were summarized. ResultsEight patients had different degree of psychonosema, and it was correlated with psychological factors, various channels of undesirable stimulation, sleep disorders, drug and other factors. After treatment and careful nursing, within three to seven days, all patients' abnormal mental symptoms were alleviated, and all of them were discharged. ConclusionThere are many factors which can cause psychonosema after laryngectomy for laryngeal carcinoma. Medical staff should try to reduce or avoid inducing factors. Once it happens, medical staff should carry out psychiatric treatment in time to avoid accidents and promote the rehabilitation of patients.
ObjectiveTo explore the expressions of polo-like kinase 1(PLK1) and serine/threonine kinase 15 (STK15) mRNA and protein in colon cancer cells, and to explore the inhibitive effect of SBE13 and VX-680 for PLK1 protein and STK15 protein. MethodsOne kind of cervical cancer cells(Hela cells) and 3 kinds of colon cancer cells (HCT-116 cells, HT-29 cells, and CACO-2 cells) were selected for experiment. Expression levels of PLK1 mRNA, STK15 mRNA and its protein of 4 kinds of cells were detected by reverse transcription polymerase chain reaction(RT-PCR) and Western blot method respectively. Inhibitive effect of SBE13 and VX-680 were evaluated in vitro by methylthiazolyldiphenyl-tetrazolium bromide(MTT) assay in 4 kinds of cells, which divided into 5 groups, receiving Dulbecco's modification of Eagle's medium(DMEM), dimethylsulfoxide(DMSO), SBE13, VX-680, and SBE13+VX-680 respectively. ResultsCompared with Hela cells, expression levels of PLK1 mRNA, STK15 mRNA and its protein in HCT-116 cells,HT-29 cells, and CACO-2 cells were higher(P<0.05). ① Hela cells:Compared with DMEM group, the proliferative activity were not inhibited in SBE13 group, VX-680 group, and SBE13+VX-680 group(P>0.05). ② HCT-116 cells and HT-29 cells:Compared with DMEM group, the proliferative activity were inhibited in VX-680 group and SBE13+VX-680 group(P<0.05), but was not inhibited in SBE13 group(P>0.05). ③ CACO-2 cell:Compared with DMEM group, the proliferative activity were inhibited in SBE13 group, VX-680 group, and SBE13+VX-680 group(P<0.05). ConclusionsExpression levels of PLK1 mRNA, STK15 mRNA and its protein increase in HCT-116, HT-29, and CACO-2 cells compared with Hela cells. SBE13 and VX-680 can inhibit PLK1 and STK15 protein partly in colon cancer cell lines.
ObjectiveTo explore the expression of Cryab in human colorectal cancer tissue and its clinical significances. MethodsTen pairs of colorectal cancer specimens of early recurrence and late recurrence in the First Hospital of Lanzhou University were collected, the Cryab mRNA expression was detected by RT-PCR. The colorectal cancer tissues and corresponding adjacent tissues of 100 patients underwent radical resection from January 2005 to December 2008 in the Donggang Branch of The First Hospital and The First Hospital of Lanzhou University were collected, the expression of Cryab protein in the colorectal cancer tissues and corresponding adjacent tissues of 100 patients with colorectal cancer were detected by immunohistochemistry SP technique. The relation between the expression of Cryab protein and the age, gender, number of tumors, tumor size, TNM stage, degree of differentiation, lymph node metastasis, or depth of invasion of the patients was analyzed. The influence of Cryab expression on prognosis of patients with colorectal cancer was evaluated by univariate and multivariate analysis. Results①The expression of Cryab mRNA in the colorectal cancer tissues with early recurrence was significantly higher than that in the colorectal cancer tissues with late recurrence (P < 0.05).②The expression of Cryab protein in the colorectal cancer tissues was significantly higher than that in the corresponding adjacent tissues (P < 0.05).③The over-expression of Cryab protein in the colorectal cancer tissues was correlated with the tumor size, degree of differentiation, lymph node metastasis, or TNM stages (P < 0.05), but not correlated with the age, sex, and number of tumors (P > 0.05).④The lymph node metastasis and expression of Cryab protein were the independent risk factors for the prognosis of patients with colorectal cancer.⑤The overall survival and disease free survival of patients with high-expression of Cryab protein were significantly lower than those in the patients with lower-expression of Cryab protein. ConclusionsThe over-expression of Cryab is closely related to the invasion and progression of colorectal cancer, they might be together involved in the progression of colorectal cancer. Cryab might be a good marker for monitoring the malignant degree and the prognosis of colorectal cancer.
The interpretation of the guideline is an important method to learn, understand and apply authoritative guidelines. This is the fourth article of the research group about evidence-based diagnosis clinical practice guidelines. We would analyze the ACR Appropriateness Criteria® Right Lower Quadrant Pain—Suspected Appendicitis from the methodological perspective which was made by American College of Radiology, referring to the standard of AGREE.
ObjectiveTo evaluate the quality of traditional Chinese medicine (TCM) guidelines, so as to provide evidence for developing similar guidelines. MethodsWe systematically searched TCM guidelines published in domestic medical journals from WanFang Data, VIP, CNKI and CBM. We also searched Google, Amazon.cn and dangdang.com by hand in order to obtain TCM guidelines published in monographs. And we used AGREE II instrument to assess the methodological quality of included guidelines. ResultsA total of 115 guidelines (87 published in domestic medical journals and 28 published in monographs) were included. Scaled domain percentages from highest to lowest were:scope and purpose (41%), stakeholder involvement (28%), clarity of presentation (33%), rigour of development (20%), editorial independence (9%) and applicability (7%). ConclusionThere is still a large gap about methodological quality between TCM guidelines and international guidelines. So the guideline developers should systematically search, evaluate and synthesize the evidence based on structured problems. At the same time, they also need to consider the costs of recommendations, the implementation environment and the patients' preference and values. On this basis, the developer could further increase the transparency and independence during developing TCM guidelines.
ObjectiveTo explore the conditions of synovial derived mesenchymal stem cells (SMSCs) differentiating into the fibrocartilage cells by using the orthogonal experiment. MethodsThe synovium was harvested from 5 adult New Zealand white rabbits, and SMSCs were separated by adherence method. The flow cytometry and multidirectional differentiation method were used to identify the SMSCs. The conditions were found from the preliminary experiment and literature review. The missing test was carried out to screen the conditions and then 12 conditions were used for the orthogonal experiment, including transforming growth factor β1 (TGF-β1), bone morphogenic protein 2 (BMP-2), dexamethasone (DEX), proline, ascorbic acid (ASA), pyruvic acid, insulin+transferrin+selenious acid pre-mixed solution (ITS), bovin serum albumin (BSA), basic fibroblast growth factor (bFGF), intermittent hydraulic pressure (IHP), bone morphogenic protein 7 (BMP-7), and insulin-like growth factor (IGF). The L60 (212) orthogonal experiment was designed using the SPSS 18.0 with 2 level conditions and the cells were induced to differentiate on the small intestinal submucosa (SIS)-3D scaffold. The CD151+/CD44+ cells were detected with the flow cytometry and then the differentiation rate was recorded. The immumohistochemical staining, cellular morphology, toluidine blue staining, and semi-quantitative RT-PCR examination for the gene expressions of sex determining region Y (SRY) -box 9 gene (Sox9), aggrecan gene (AGN), collagen type I gene (Col I), collagen type Ⅱ gene (Col Ⅱ), collagen type IX gene (Col IX) were used for result confirmation. The differentiation rate was calculated as the product of CD151/CD44+ cells and cells with Col I high expression. The grow curve was detected with the DNA abundance using the PicoGreen Assay. The visual observation and the variances analysis among the variable were used to evaluate the result of the orthogonal experiment, 1 level interaction was considered. The q-test and the least significant difference (LDS) were used for the variance analysis with a type Ⅲ calibration model. The test criteria (α) was 0.05. ResultsThe cells were certified as SMSCs, the double-time of the cells was 28 hours. During the differentiation into the fibrocartilage, the volume of the SIS-3D scaffold enlarged double every 5 days. The scaffolds were positively stained by toluidine blue at 14 days. The visual observation showed that high levels of TGF-β1 and BMP-7 were optimum for the differentiation, and BMP-7 showed the interaction with BMP-2. The conditions of DEX, ASA, ITS, transferrin, bFGF showed decreasing promotional function by degrees, and the model showed the perfect relevance. P value was 0.000 according to the variance analysis. The intercept analysis showed different independent variables brought about variant contribution; the TGF-β1, ASA, bFGF, IGF, and BMP-7 were more remarkable, which were similar to the visual observation. ConclusionIn the process of the SMSCs differentiation into the fibrocartilage, the concentrations of TGF-β1, ASA, bFGF, and IGF reasonably can improve the conversion rate of the fibrocartilage cells. The accurate conditions of the regulatory factor should be explored further.
ObjectivesTo evaluate the methodological bias and the reliability of the conclusions of systematic reviews (SRs) of lanthanum carbonate in the treatment of chronic kidney disease with hyperphosphatemia. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library, PROSPERO, CNKI, CBM, WanFang Data and VIP to collect systematic reviews and meta-analysis about lanthanum carbonate in the treatment of chronic kidney disease with hyperphosphatemia from inception to August 31st, 2016. Two reviewers independently screened literature and extracted data, then AMSTAR tool was used to assess the methodological quality of included studies and the GRADE tool was used to grade the evidence quality of outcome measures included in the SRs. ResultsA total of eight relevant SRs were included and containing three main outcome measures. The assessment results of AMSTAR tool suggested that:four SRs were of high quality, and the other four were of medium quality. GRADE results showed:for serum phosphorus level, compared with placebo, the quality of the evidence of three SRs were medium, low and very low; compared with calcium carbonate or conventional phosphorus binder, four SRs were low, low, low and very low; compared with sevelamer, one SR was low. For serum calcium level, compared with placebo, the quality of the evidence of three SRs were high, medium and low, respectively; compared with calcium carbonate or conventional phosphorus binder, five SRs were low, low, low, very low and very low; compared with sevelamer, one SR was very low. For serum iPTH level, compared with placebo, the quality of the evidence of three SRs were medium, low and very low; compared with calcium carbonate or conventional phosphorus binder, five SRs were medium, low, low, very low and very low; compared with sevelamer, one SR was low. ConclusionAt present, methodological quality assessment for the treatment of hyperphosphatemia in chronic kidney disease with lanthanum carbonate is generally not high and the level of evidence for the conclusion is generally low. In drug safety, especially in the occurrence of adverse events of the digestive system is still controversial, and a large amount of high quality experimental is needed to demonstrate the safety of its long-term use. Clinicians need to be cautious in using these evidence to make clinical decisions.