Objective To explore the role of human urinary trypsin inhibitor(UTI) in severe acute pancreatitis (SAP). Methods UTI was highly purified from the urine of patients with acute pancreatitis by column chromatography. SAP models were established by injection of 5% sodium taurocholate(NaTc) at dose of 0.1 ml/100 g weight under pancreatic capsule. The interleukin 6(IL 6) level in each group was measured by ELISA. Results ① The highly purified UTI with high yield was harvested. ② SAP models were established successfully. ③ The level of IL 6 in SAP group was significantly higher than that in NC, but in UTI group, the increase was not obvious. Conclusion The alleviating effect of UTI on the pathological damage degree in rats with SAP is related to the inhibitive effect of UTI on the expression of IL 6.

Objective To research the indoor air pollution in offices induced by decoration and its health effects. Methods According to the completed time, the offices were divided into 6 groups (2 month group, 2-4 month group, 5-8 month group, 9-11 month group, 12-18 month group, over 5 year group). The concentration of indoor air pollutants was determined and 617 people from the decorated offices were randomly selected to finish the questionnaires on health. Results The over standard rate of formaldehyde, benzene and ammonia in indoor air was the highest in 2 month group, 100%, 87.3%, 83.9% respectively. The concentration of indoor air pollutants decreased as the time went on, about one year after decoration, the concentrations were lower than the standard limits (GB/T 18883-2002). The adverse response rate of the staff members in offices decorated group (76.4%) was significantly higher than that in the control group (30.9%) (P

Objective To explore the effects of formaldehyde (FA) on the contents of CD3, CD4, CD8 and the activity of SOD and the contents of MDA in the spleen and thymus of mice. Methods 30 Kunming mice were randomly divided into 5 groups, 6 in each and treated with FA: the negative control group, 1 mg/m3, 3 mg/m3, 5 mg/m3 and the positive control group (treated with cyclophosphamide, CP). The mice were exposed to FA by static state inhalation in a chamber for 14 days, then the contents of CD3, CD4, CD8, MDA and the activity of SOD in the liver, spleen and thymus were determined. Results The contents of CD3, CD4, CD8 in the spleen and thymus showed a significant decreasing as the exposure dose increasing, an obvious dose-response relation was seen and there were significant differences between FA exposed groups and the control group (P

Objective To investigate the expression of inflammtory factor genes change induced by sodium sulfite.Methods MTS assay was used to detect the cell toxicity to human embryonic kidney cell line 293(HEK293) of 0,0.0025,0.01,0.039,0.156,0.625,2.5,10 mmol/L sodium sulfite,morphological changes were observed with inversion microscope and RT-PCR was used to study the expression of mRNA changes of TNF-?,MCP-1 and IL-8.Results Cytotoxicity analysis showed that treatment of cells with 0.625,2.5,10 mmol/L Na2SO3 could significantly decrease the OD value,with the OD value of(0.354 75 ?0.021 24),(0.600 50?0.012 77),(0.784 75?0.009 85) respectively,compared with control group(2.514 5?0.202 265).When treated with ≤0.156 mmol/L Na2SO3,it sould not significantly affect cell viability,with the OD value of(2.473 75?0.069 99)-(2.625 00? 0.120 29).Morphological observation showed that exposure of ≥0.625 mmol/L Na2SO3 could decrease cell numbers significantly and living cells seemed narrower and longer than the usual way with fewer evection.But lower concentrations of Na2SO3(≤0.156 mmol/L) did not change cell numbers and cell morphology.RT-PCR result showed that treatment of 0.039-10 mmol/L Na2SO3 could not induce the expression of TNF-?,MCP-1 and IL-8.Conclusion Na2SO3 can cause significant inhibition and injury in HEK293,but can not up regulate the expression of mRNA of TNF-?,MCP-1 and IL-8,and there is no obvious relation between them.

Objective To investigate the effects of Na +-dependent high-affinity dicarboxylate cotransporter 3(NaDC3) and glucose on the transport of succinate in human proximal tubular epithelial cells (HKC) . Methods Western blot was used to detect the expression of hNaDC3 protein in the pcDNA3-hNaDC3, pcDNA3-AhNaDC3 and pcDNA3, transfected HKC, and normal HKC cell. Analysis of succinate contents in the intaking-buffer at the various time points and in the variouse concentrations of glucose were determined by capillary zone electrophoresis. Results The cell transfected with pcDNA3- hNaDC3 was found to have over-expression of hNaDC3 protein for about 1.5 times that of the normal HKC, while succinate content in intaking-buffer was decreased. Although the cells transfected with pcDNA3-AhNaDC3 showed lower expression of hNaDC3 protein, being about 0.6 times that of normal HKC cells, the decrease of succinate in intaking buffer was not obviously effected. There were no differences in hNaDC3 protein content and succinate intaking between the cells transfected with pcDNA3 and normal HKC cells. With the increase in glucose concentration, the decrease of succinate in intaking-buffer was accelerated. Conlusion The results suggested that the overexpression of hNaDC3 protein can cause the succinate-intake more quickly in HKC.

Objective To assess the efficacy and safety of over-the-scope clip(OTSC) system in treatment of the perforation ,fistula and bleeding of the digestive tract .Methods The data of 33 patients who were treated with OTSC in our department were analyzed retrospective-ly,and the technical success rate ,clinical success rate and complications were statistically analyzed .Among the 33 patients,there were 14 pa-tients with upper gastrointestinal bleeding , 8 patients with postoperative fistula , and 11 patients with endoscopic full-thickness resection (EFTR) of gastric or duodenal bulb.Results The technical success rate and clinical success rate of 33 cases were 96.97% and 93.94%respectively,and there was no complication in all patients .Among them,the clinical success rate of the upper gastrointestinal bleeding was 92.85%,the anastomotic fistula was 75.00%,and the EFTR was 100%.Conclusion As a new type of clinical endoscopic suture system , OTSC is safe and effective in gastrointestinal bleeding ,perforation and fistula .

Objective To survey the current situation of core competence and job burnout for nursing professional teachers in college and to analyze the correlation between them.Methods 210 nursing teachers from 16 colleges and universities were investigated with the core competence evaluation questionnaire for nursing professional teachers and Chinese Maslach Burnout Inventory (CMBI).Results The mean score of core competence for college nursing professional teachers was (2.67±0.79) points,which was at the middle low level.The overall level of job burnout for college nursing professional teachers was between none and moderate.There was significant positive correlation between job burnout and core competence,the leadership competence,problem solving competence,professional competence,teaching competence.Conclusions The job burnout level for nursing professional teachers in college is lower than the moderate level.The core competence increases with the increase of job burnout level.Making mild stress for teacher and keeping the job burnout at mild-moderate level can improve the core competence of nursing teachers in College

Objective To explore the clinical effects of S-1 single agent chemotherapy for the patients undergoing radical resection of cholangiocarcinoma.Methods The clinical data of 51 patients receiving radical resection of cholangiocarcinoma who were admitted to the Second Affiliated Hospital of Zhejiang University from November 2011 to December 2013 were retrospectively analyzed.After radical resection of cholangiocarcinoma,25 patients receiving non-special treatment and 26 patients receiving S-1 single agent chemotherapy were divided into the operation group and chemotherapy group,respectively.S-1 was taken orally twice per day.Forty mg/once of S-1 was applied to patients with the body surface area ＜ 1.25 m2,50 mg/once of S-1 was applied to patients with the body surface area ≥ 1.25 m2 and ＜ 1.50 m2,and 60 mg/once of S-1 was applied to patients with the body surface area ≥ 1.50 m2.The 14 days usage and 7 days withdrawal of S-1 were used as one course of treatment.The standard usage of S-1 was 6-8 courses of treatment.All the patients were followed up by outpatient examination and telephone interview till December 1,2014.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Twenty-six patients in the chemotherapy group finished the courses of chemotherapy without chemotherapy-related death,and 14 patients had chemotherapy adverse reactions with remission after discontinuation of S-1.All the 51 patients were followed up for 5-37 months with a median time of 19 months.The median overall survival time,1-,3-year overall survival rates,tumor-free median survival time and 1-,3-year tumor-free survival rates were 22 months (range,18-27 months),72.3％,42.9％,21 months (range,16-26 months),60.0％,55.0％ in the operation group and 32 months (range,29-35 months),84.6％,44.4％,26 months (range,21-31 months),76.9％,61.9％ in the chemotherapy group,respectively.There was a significant difference in the overall survival between the 2 groups (x2=6.032,P ＜ 0.05).There was no significant difference in the tumor-free survival between the 2 groups (x2=0.498,P ＞ 0.05).Conclusion S-1 single agent chemotherapy after radical resection of cholangiocarcinoma could improve the survival of patients,while no obvious advantages of inhibiting tumor recurrence is observed.

Objective To investigate the application value of percutaneous sinus-tract cholangioscopy in the diagnosis and treatment of residual intra-and extra-hepatic bile duct stones.Methods The retrospective cross-sectional study was conducted.The clinical data of 1 045 patients with intra-and extra-hepatic bile duct stones who underwent percutaneous sinus-tract cholangioscopy or stone extraction in the Second Affiliated Hospital of Zhejiang University from January 2003 to June 2016 were collected.Patients received percutaneous sinus-tract cholangioscopy or stone extraction at 6-8 weeks after T tube drainage.Observation indicators:(1) diagnosis and stone extraction situstions:cases with residual stones,stone extraction frequency and clearance rate;the critics of clearance rate are no residual stone dnring operation combined with B ultrasound or T-tube cholangiography;(2) postoperative complications:incidence and management of postoperative complications,prognosis and ClavienDindo classification for postoperative complication;(3) follow-up situation.T-tube was removed when there was no residual stone.Patients were followed up by outpatient examination up to April 2017.B ultrasound reexamination was performed to detect the recurrence of stone once every 3-6 months.Results (1) Diagnosis and stone extraction situstions:among 1 045 patients,results of cholangioscopy showed 147 wihout bile duct stones and 898with bile duct stones.Of 898 patients,2 618 times cholangioscopic explorations for stone extraction were performed,with a maximum frequency of 16 times,and 851 had stones clearance,with a overall clearance rate of 94.77％(851/898).The clearance rates of extra-and intra-hepatic bile duct stones were 100.00％(221/221) and 93.06％(630/677).Of 47 patients with residual stones,16 didn't receive cholangioscopy due to branches stricture or occlusion of intrahepatic duct,13 failed to take out stone due to T-tube dislodgement (9 cases) and improper placement (4 cases) induced closed T-tube sinus tract,7 had T-tube sinus tract duodenal fistula,6 gave up stone extraction,3 was due to longer sinus tract induced bending and 2 was due to T-tube sinus tract fracture.(2)Postoperative complications:among 1 045 patients,297 had level Ⅰ-Ⅱ mild complications and 13 had level Ⅲand above severe complications.The common complications included fever,vomiting,diarrhea and so on;the special complications included T-tube sinus tract duodenal fistula of 13 patients,T-tube sinus tract fracture of 4 patients,rupture of broken stones pole of 3 patients,massive hemobilia of 2 patients,acute pancreatitis of 2patients and cardiac arrest of 1 patient.The above complications were improved by symptomatic and supportive treatments.(3) Follow-up situation:among 1 045 patients,558 received long-term follow-up,with follow-up time of 10-171 months and a median time of 79 months.Eight-four patients had stone recurrence.Of 13 patients with recurrence of extrahepatic bile duct stones,7 took out stones by endoscopic retrograde cholangio pancreatography (ERCP) and 6 underwent reoperations.Of 71 patients with recurrence of intrahepatic bile duct stones,43underwent reoperations and 28 received conservative treatment.Conclusions Percutaneous sinus-tract cholangioscopy for residual intra-and extra-hepatic bile duct stones is safe and effective,with good diagnosis and treatment values and a high clerance rate.The integrity of T-tube sinus-tract is a key of complete stones removal.

Objective To evaluate the efficacy and safety of clip traction in endoscopic submucosal dissection (ESD) for heterotopic pancreas in stomach.Methods Data of 62 patients with pathologically confirmed heterotopic pancreas treated by ESD between May 2013 and February 2016 were retrospectively studied in Department of Gastroenterology of Xinqiao Hospital,whose lesions were single and origins were submucosal.Thirty-six cases underwent ESD with clip traction (clip group,n=36),and 26 cases underwent ESD without clip traction (non-clip group,n =26).The procedure time,visualization of the submucosal during dissection,complications and the result of follow-up were evaluated between the two groups.Results ESD was successful in all cases.The procedure time was significantly shorter in the clip group than in the non-clip group (19.35±10.34 min VS 27.02± 14.27 min,t'=2.333,P=0.023),and good visualization was obtained by applying clip traction.The rate of bleeding in the clip group was 55.6％ (20/36),and that in the non-clip group was 61.5％ (16/26).There was no significant difference between the two groups(x2 =0.222,P =0.638).Moreover,perforation did not occur in the clip group,but occurred in one patient in the non-clip group (3.8％,1/26).There was no significant difference between the two groups (P =0.419).All patients were followed up,there was no recurrence.Conclusion ESD is effective and safe for heterotopic pancreas in stomach.Clip traction can shorten the operation time and reduce complications of ESD.