Objective To investigate the effects of intestinal ischemia reperfusion (IIR) on the progression of inflammatory reaction in hemorrhagic necrosis pancreatitis (HNP).Methods Eighty rats were randomly divided into sham operation (SO) group,acute edematous pancreatitis (AEP) group,AEP + IIR group and HNP group according to the random number table.Erythrocyte velocity (EV),functional capillary density (FCD) and leukocyte adherence (LA) were observed at 0,1,2,3 and 6 hours after the models were completed.The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected.All data were analyzed by using the analysis of variance or the t test.Results The level of EV in the AEP group significantly decreased at 1 hour,and got increased at 3 hours,while the level of EV in the AEP group was still significantly lower than that in the SO group ( t =9.60,P ＜ 0.05 ).The levels of EV in the AEP + IIR group and HNP group constantly decreased,and increased at 6 hours,but were continually lower than that in the AEP group ( t =6.03,6.12,P ＜0.05 ).The level of FCD in the AEP group was significantly lower than that in the SO group at 3 hours ( t =8.20,P＜0.05).The levels of FCD in the AEP + IIR group and HNP group were significantly lower than that in the AEP group at 3 hours (t =35.60,23.80,P ＜ 0.05 ).Compared with AEP group,the level of LA in the AEP group was significantly increased at 1 hour ( t =75.00,P ＜ 0.05 ) and reached peak at 3 hours.The levels of LA in the AEP + IIR group and HNP group were significantly higher than that in the AEP group at 1,2,3,6 hours (t =23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).Compared with SO group,the level of TNF-α in the AEP group significantly increased since l hour (t =77.00,P ＜ 0.05),and began to decrease at 3 hours; the levels of TNF-α in the AEP +IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =23.50,18.10,P＜0.05).The levels of IL-6 in the AEP group at 1,2,3,6 hours were significantly higher than those in the SO group ( t =93.50,146.00,243.60,209.20,P ＜ 0.05 ).The levels of IL-6 in the AEP + IIR group and HNP group at 1 hour were not significantly different from that in the AEP group ( t =2.30,2.03,P ＞ 0.05),while the levels of IL-6 in the AEP + IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =35.63,29.80,P ＜ 0.05 ).Conclusion IIR may enhance the inflammatory reaction of AEP and IIR might be one of the factors to exaggerate the inflammatory reaction of HNP.

Objective To explore the therapeutic effect of immune regulating nutrition on severe acute pancreatitis (SAP). Methods The clinical data of 80 patients with SAP who were admitted to the Union Hospital of Huazhong University of Science and Technology from February 2008 to October 2009 were prospectively analyzed. The 80 patients were equally divided into conventional nutrition (CN) group and immune regulating nutrition (IRN) group. Patients in the CN group received CN support, while patients in the IRN group were supplemented with ω-3 polyunsaturated fatty acid (ω-3 PUFA ) and glutamine at the basis of CN support.APACHE Ⅱ scores were evaluated at day 1, 4, 7, 10, 14 in the course of treatment. The differences in the incidence of pulmonary and abdominal infection, sepsis, and other clinical parameters including operation intervention, mortality, length of ICU and hospital stay between the two groups were compared. All data were analyzed using the t test and chi-square test. Results The APACHE Ⅱ scores of patients in the IRN group were 15.3 ± 1.8 and 9.0 ± 1.8 at day 4 and 7, which were significantly lower than 20.0 ± 2.7 and 13.3 ± 2.4 in the CN group, respectively (t = 3.3, 2. 8, P < 0.05). The APACHE Ⅱ scores of patients in the IRN group at day 10and 14 were also lower than those in the CN group, while there was no significant difference (t =0. 7, 0. 6, P>0.05). The incidences of pulmonary and abdominal infection and surgical intervention rate in the IRN group were 18% (7/40), 13% (5/40) and 5% (2/40), which were significantly lower than 38% (15/40), 33% (13/40)and 20% (8/40) in the CN group, respectively (χ2 =4.0, 4.6, 4.1, P<0.05). The incidence of sepsis in the IRN group was 5% (2/40), which was lower than 8% (3/40) of the CN group, while there was no significant difference between the two groups ( χ2 =0.0, P >0.05 ). The average lengths of ICU and hospital stay in the IRN group were (5.4 ± 1.6 ) days and ( 38.6 ± 9.3 ) days, which were significantly lower than ( 7.8 ± 2.8 ) days and (43.1 ± 1 1.6) days in the CN group, respectively ( t = 2. 7, 3. 7, P < 0.05 ). The morality was 5% (2/40) in the IRN group and 8% (3/40) in the CN group, with no significant difference between the two groups (χ2 =0.0,P >0.05). Conclusion CN support supplemented with ω-3 PUFA and glutamine can adjust the inflammation reaction of SAP and sustain the normal immune function, which is helpful in decreasing the incidence of severe infection.

Objective To investigate the effect of vacuum-assisted closure(VAC)on the circulating number of endothelia progenitor cell(EPCs)in diabetic patients with mild to moderate degrees of ischemic foot ulcer and their related factors. Methods A total of 84 diabetic patients with foot ulcer duration for at least 4 weeks and ankle brachial index(ABI)0.5~0.9 were selected and divided into and assigned to two groups according to 2: 1 randomization:vacuum-assisted closure(VAC)treatment group(n=56)and Non-VAC treatment group(n=28). The control group (NC) was composed of 18 patients who had normal glucose tolerance and lower extremity ulcer without arteriovenous disease. VAC was performed on the ulcer wound after debridement for 1 week in both VAC group and NC group,and the patients in Non-VAC group received conventional treatment process. The circulating number of EPCs was measured before and after various treatments and the influencing factors of their changes were analyzed. Results After VAC treatment,the circulating number of EPCs significantly increased in both VAC group and NC group[(85.3 ± 18.1)vs(34.1 ± 12.5)/106cells,(119.9 ± 14.4)vs(66.1 ± 10.6)/106cells,both P<0.05]. By contrast,the circulating number of EPCs had no significant change in Non-VAC group[(45.2 ± 19.4)vs(34.7 ± 16.8)/106cells, P>0.05]. In addition,the circulating levels of vascular endothelial growth factor(VEGF)and the protein expressions of VEGF and stromal cell-derived factor-1α(SDF-1α)in the granulation tissue also significantly increased after VAC treatment in both VAC group and NC group,but no significant change in Non-VAC group. Compared with Non-VAC group,the changes of VEGF and SDF-1α levels in the sera and granulation tissue were all significantly higher in both VAC group and NC group(P<0.05 or P<0.01). There were no significant differences in changes of the circulating number of EPCs, and VEGF and SDF-1α in the sera and granulation tissue between VAC group and NC group. Correlation analysis showed that the change of the circulating number of EPCs was correlated with the changes of VEGF and SDF-1α levels in the sera and granulation tissue of VAC group and NC group(P<0.05). Conclusion VAC treatment may increase the circulating number of EPCs in diabetic patients with mild to moderate ischemic foot ulcer as in non-diabetic controls,which may be attributed to the upregulation of systemic and local VEGF and SDF-1α levels.

BackgroundPatients with schizophrenia of Yangming Fushi syndrome experience more severe symptoms， and a substantial proportion of patients derive inadequate benefit from antipsychotics and suffer from serious adverse effects， yet few studies have been conducted on the treatment of schizophrenia of Yangming Fushi syndrome with Zengye Chengqi decoction. ObjectiveTo explore the efficacy of Zengye Chengqi decoction combined with olanzapine in the treatment of schizophrenia of Yangming Fushi syndrome， in order to provide references for the treatment of schizophrenia with the combination of traditional Chinese and western medicine. MethodsA total of 60 patients attending the Second Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2023 and fulfilling the International Classification of Diseases （ICD-10） diagnostic criteria for schizophrenia were enrolled， and assigned into study group （n=30） and control group （n=30） using random number table methods. All patients were treated with olanzapine， and study group was given Zengye Chengqi decoction on this basis. Treatment for both groups lasted for 4 weeks. All participants were assessed using Positive and Negative Syndrome Scale （PANSS）， Montreal Cognitive Assessment （MoCA） and Event-Related Potential P300 at baseline and end of treatment. The occurrence of adverse reactions was recorded at the end of treatment. ResultsStudy group reported a higher treatment effective rate compared with control group （χ²=9.320， P=0.002）. After treatment， study group detected a significant reduction in PANSS subscales and total scores （F=10.287， 8.258， 8.844， 20.079， P<0.01）， and a notable increase in scores of delayed recall and orientation domains from MoCA （F=4.463， 22.255， P<0.05 or 0.01） when compared with control group， with statistical difference. For the P3 component of event-related potential， study group produced significantly larger amplitudes than control group （F=4.247， P<0.05）. The incidence rate of abnormal liver function， constipation and increased body mass index （BMI） in study group was lower than those in control group （χ²=4.320， 4.463， 7.200， P<0.05 or 0.01）. ConclusionZengye Chengqi decoction combined with olanzapine are found to be effective in improving the psychotic symptoms and cognitive function and alleviating the adverse reactions of patients with schizophrenia of Yangming Fushi syndrome. ［Funded by Open Project of Psychiatry and Neuroscience Discipline of Second Affiliated Hospital of Xinxiang Medical College （number， XYEFYJSSJ-2023-09）； www.chictr.org.cn number： ChiCTR2200057743］

Objective: To explore the effect of nursing scheduling software combined with mobile phone APP in the nursing manpower arrangement in intensive care unit. Methods: The nursing scheduling software and mobile phone APP were applied to management resources of 82 nurses in ICU, substituted for traditional manual way. The work efficiency, nursing quality and nurse satisfaction were compared before and after implementing in intensive care unit. Results: After implementation of nursing scheduling software combined with mobile phone APP, the average time of scheduling was reduced from (6.49±0.62) h to (4.29±0.44) h, the difference was statistically significant (t=19.97, P<0.01). The nursing quality score was improved from (97.54±1.19) points to (95.16±1.29) points, the difference was statistically significant (t=-4.70, P<0.01). The nurses′ satisfaction about scheduling was improved from 73.2%(60/82) to 96.3%(79/82), the difference was statistically significant (χ²=17.04, P<0.01). Conclusions The mode of nursing scheduling software combined with mobile phone APP in intensive care unit has a good effect, which can improve the scheduling efficiency, the job satisfaction of nursing staff and the quality of nursing,and promote the nursing information management.