China ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Meridians ; Phytotherapy ; Taiwan ; Yin-Yang

Radical pancreaticoduodenectomy is the most effective method for the treatment of malignant tumor of pancreatic head.Safe and complete resection of the uncinate process of the pancreas is the most difficult and important part in radical pancreaticoduodenectomy.For the past years,we put forward the new idea of prior selective arteriovenous treatment in radical pancreaticoduodenectomy according to whether the portal vein and superior mesenteric vein was invaded by the tumor.Thin slice scan and vessel reconstruction using multidetector spiral CT can accurately evaluate the condition of the blood vessels near the pancreatic tumor and judge whether the tumor was resectable.By exchanging superior mesenteric artery,controlling blood stream of pancreatic uncinate process and using 3 or 4 vascular blocking bands and the integrated radical resection of uncinate process for those patients can be successfully completed.It can reduce the operating bleeding,operating time and the miscut of superior mesenteric vein and (or) superior mesenteric artery,and also avoid postoperative pancreas necrosis,infection and hemorrhage caused by the pancreas uncinate process residues,and theoretically reduces the chance of tumor cells spread.

Objective To draw up the psychological selection inventory for the nurses in war. Methods Quantitative and qualitative methods were used to confirm the elements, on this basis formal inventory was obtained from inventory was obtained,reliability and validity of the formal inventory wad analyzed through a survey for 977 nurses who took part in emergent nursing activities. Results This article obtained accountability, confidence, compassionate, alertness, braveness, pertinacity and communication seven factors. The psychological selection inventory for the nurses in war was authorized on the basis of the seven factors. There were 90.91% items which discrimination ≥0.2, the retest coefficient of the whole inventory was 0.8719, the retest coefficient of the factors was between 0.6753 and 0.8654, the Cronbach coefficient of the whole inventory was 0.9147, the Cronbach coefficient of the factors was between 0.6462 and 0. 8344, the correlation coefficient of the factors was between 0. 3126 and 0. 5409. Conclusion The inventory has good reliability and validity, and it has significant meaning on the selection and training of the nurses in war.

Objective To assess the application of intracavitary electrocardiography (IC-ECG) during the insertion of the Groshong peripherally inserted central catheters (PICC).Methods A total of 168 patients (aged 20-76 years) with gynecologic tumors who required the insertion of Groshong PICC because of various clinical conditions between January 2013 and December 2014 were selected into this study in Zhongnan Hospital of Wuhan University.During PICC insertion, the P-wave of IC-ECG helped general judgments about the position and direction of the tip of catheters, hence guiding the intubation.Precise position was determined by Xray following the fastening of catheters, based on which the accuracy and sensitivity of IC-ECG in the insertion of Groshong PICC were evaluated.Results All the cases presented typical changes of P-wave.However, 15 cases exhibited no such alternations in the first placement however deep or shallow the catheters were, in whom the typical P-wave was induced after withdrawal and replacement of the catheters with adjustment of patient position.According to the X-ray (gold standard), the accuracy and sensitivity of IC-ECG in diagnosing position of tip in the superior vena cava (SVC) were 98.8％ and 98.8％, respectively.The accuracy of diagnosing the position at the optimum location in the SVC reached 97.0％.Conclusions A high peaked P-wave of similar shape could be observed in IC-ECG in the insertion of Groshong PICC.IC-ECG could remarkably increase the positioning accuracy of PICC tip into the SVC;meanwhile, the optimal inserted length of the catheters could be determined by monitoring the changes of the P-wave with IC-ECG during insertion.

To investigate the effects of Xiaoyao Powder, a compound traditional Chinese herbal medicine for treatment of depression, on monoamine neurotransmitters in hippocampus of rats with postpartum depression (PPD).

Objective To study the chemical constituents from the seeds of Ziziphus jujuba var.spinosa,which is used as a sedative herbal medicine in China.Methods The constituents were separated and purified by silica gel column.Their structures were elucidated based on their physicochemical properties and spectral analysis.Results Six compounds were obtained from 95% EtOH extracts in the seeds of Z.jujuba var.spinosa.They were identified as 2?,3?-dihydroxy-lup-20(29)-en-28-oic acid methyl ester(Ⅰ),?-sitosterol(Ⅱ),betulin(Ⅲ),betulinic acid(Ⅳ),hexadexanoic acid 2,3-dihydroxypropyl ester(Ⅴ),and daucosterol(Ⅵ).Conclusion Compound Ⅰ is a novel lupane triterpene named as alphitolic acid methyl ester,compound Ⅴ is obtained from the seeds of Z.jujuba var.spinosa for the first time.

Three-dimensional cell culture is widely recognized as a model in vitro that can better simu-late the interaction between tumor cells in vivo and cell microenvironment. Compared with the traditional two-dimensional cell culture,it has obvious advantages in the study of the observation of tumor cells biological be-havior,tumor resistance,radiation insensitivity,gene expression in vivo and in other aspects of the study. It can provide a valuable model in vitro for experimental study on the basis of tumor.

Objective To study the influence of artifical liver support system (ALSS) on bone marrow stem cell (BMSC) differentiation factors in patients with chronic severe hepatitis B.Methods Fifty patients with chronic severe hepatitis B were divided into ALSS treatment group (n=25) and control group (n=25).The patients in control group received combined medical treatment and those in ALSS treatment group received ALSS treatment within 1 week of admission on the basis of combined medical treatment.The concentrations of hepatocyte growth factor(HGF),fibroblast growth factor-4 (FGF-4),epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) were detected before and 2 weeks after therapy.The data were analyzed by t test.Results The serum levels of HGF,FGF-4,EGF and bFGF of patients before ALSS treatment in treatment group were (689.10± 337.68) ng/L,(124.88±87.67) ng/L,(323.85±44.40) ng/L and (9.29± 1.38) ng/L,respectively; while the levels of those cytokines after ALSS treatment were (1081.50±356.66) ng/L,(110.76±79.71) ng/L,(347.80±71.73) ng/L and (9.57±1.15) ng/L,respectively,among which HGF level increased significantly after ALSS treatment (t =10.042,P＜0.01) and was higher than control group(t=6.670,P＜0.01).However,the levels of HGF,FGF-4,EGF and bFGF were not significantly different from those in the control group.And levels of all HGF,FGF-4,EGF and bFGF in control group were not statistically different before and after treatment.ConclusionALSS treatment can increase the serum HGF level but not FGF-4,EGF and bFGF,which may contribute to BMSC transdifferentiation that is involved in the hepatocyte repair and regeneration in chronic severe hepatitis B.

Objective To summarize the perioperational nursing strategies for patients undergoing mandibular defect repair by forearm flap composite fibula flap.Methods From January 2009 to December 2012,9 patients with mandibular defect and soft tissue defects after resection of malignant tumors received fibula flap and forearm flap.Before operation,the patient received psychological education and the preparation of donor flap and receptor area together with oral preparation was performed.After operation,the vital signs and blood circulation in the flap were observed.Results The fibula and forearm flaps in 8 patients survived.The fibula flap in one patient survived while the forearm flap developed with vascular crisis.The success rate for the transplanted flap was 89.9%. Conclusion The perioperative nursing strategies are key to increase survival rate of flaps and the success rate of operation.