Objective To investigate the clinical value of the duodenum double lumen cannula suction in duodenal rupture repair.Methods According to the operation methods,60 patients with duodenal rupture undergoing duodenal repair were divided into the surgical drainage alone group(26 cases)and double sets attract tube group (34 cases).The surgery effect and complications were observed.Results The difference of traffic flow 7 days after the operation between the two groups was statistically significant(t =7.564,P <0.05).The length of stay and hospital costs of the surgical drainage alone group were more than those of the double sets attract tube group,the differences were statistically significant(t =3.567,4.123,all P <0.05).The fistula,intra -abdominal infections,wound infec-tions,pulmonary infection rates of the surgical drainage alone group were 30.77%,42.31%,46.15%,26.92%, which were higher than 2.94%,11.76%,8.82%,2.94%,5.88% of the double sets attract tube group,the differ-ences were statistically significant(χ2 =8.949,7.330,10.950,2.986,5.116,all P <0.05).Conclusion Applica-tion of the double lumen cannula duodenal suction in duodenal rupture repair can significantly reduce the incidence of postoperative complications,has certain security,it is recommended in clinical practice.

BACKGROUND:The researches about the effect of retinoic acid on the proliferation of adipose-derived stem cells are rare, and the researches on the testosterone are mainly on the inhibition of cellaging. OBJECTIVE: To study the effects of retinoic acid and testosterone or combination on the cellcycle of adipose derived stem cells. METHODS:Adipose derived stem cells were isolated from adult female Sprague Dawley rats with 2 months age and cultured in vitro til passage 3 adipose derived stem cells, and then the 3rd passage adipose-derived stem cells were performed with adipogenic induction, osteogenic induction and surface marker identification. The cells were divided into six groups:(1) Control group;(2) 10-5 mol/L retinoic acid group;(3) Retinoic acid group;(4) 10-5 mol/L retinoic acid+testosterone group;(5) 10-6 mol/L retinoic acid+testosterone group;(6) Testosterone group. The adipose-derived stem cells in the control group were cultured with Dulbecco’s modified Eagle’s medium+10%fetal bovine serum culture medium, and the adipose-derived stem cells in the other five groups were induced with corresponding dose of retinoic acid and testosterone on the basis of control group. After cultured for 36 hours, the flow cytometry was used to detect the changes of cellcycle. RESULTS AND CONCLUSION:Compared with the control group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group were increased significantly, and the cellproportions in phase S were decreased. Compared with control group, the cellproportion in phase G 1 of testosterone group was significantly reduced, and the cellproportion in phase S was increased. Compared with 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid+testosterone group and 10-6 mol/L retinoic acid+testosterone group were reduced significantly and the cellproportions in phase S were increased. Retinoic acid can inhibit the cellcycle of adipose-derived stem cells in phase G 1 , and delay the process of the cellcycle from phase G1 to phase S;while testosterone can promote the cellcycle of adipose-derived stem cells from phase G1 to phase S;the combination induction of retinoic acid and testosterone can accelerate the process of the cellcycle of adipose-derived stem cells from phase G 1 to phase S.

Objective To investigate the different responses of diaphragm and peripheral muscles to cisatracurium in rabbits.Methods 8 male New zealand rabbits were anaesthetized with pentobarbital,and then the diaphragm,tibialis anterior,soleus muscles,phrenic nerves,tibial nerve,and peroneal nerve were gently freeded.The muscles were secured to force displacement transducers,and the nerves were directly stimulated by electrodes with supramaximal square waves.The isometric force of twitch tention of each muscle was recorded.The cumulative dose-response technique was separately used for obtaining the ED50and ED95 values of the cisatracurium in each muscle.Results The muscle-relaxing of cisatracurium on the three muscles in were observed in a dose-dependent manner.The ED50 values and ED95 values were: diaphragm(39.3 ± 2.5)μg/kg and(75.7 ± 4.2)μg/kg,tibialis anterior(80.6 ± 7.5)μg/kg and(123.3 ±9.3)μg/kg,soleus(80.0 ± 7.1)μg/kg and(126.9 ± 9.4)μg/kg,respectively.It had significant difference between diaphragm vs tibialis or soleus,P ＜ 0.05.Conclusions The muscle relaxant effects of cisatracurium on diaphragm and peripheral muscles were different,and diaphragm was more sensitive than peripheral muscles.

Objective? To explore the effects of case combined with Micro-lecture teaching in perioperative nursing teaching among gastrointestinal cancer patients. Methods? From January 2015 to December 2018, we selected 128 nursing students with practice in the Hangzhou First People's Hospital as subjects by convenience sampling. Nursing students with practice from January 2015 to December 2016 were in control group (n=64). A total of 64 practice nursing students from January 2017 to December 2018 were in observation group. Control group adopted case teaching, while observation group carried out case combined with Micro-lecture teaching. The teaching effects were assessed with the Self-Rating Scale for Self-Directedness in Learning (SRSSDL) and the Chinese version of the Competency Inventory for Nursing Students (CINS). Results? After teaching,the total scores of SRSSDL and CINS as well as dimension scores of observation group were higher than those in control group with statistical differences (P＜ 0.05). Conclusions? Case combined with Micro-lecture teaching can improve self-directedness learning ability and core competency of practice nursing students to guarantee the nursing teaching quality.

OBJECTIVETo investigate whether adipose-derived stem cells (ADSCs) induced by retinoic acid (RA) in vitro express primordial germ cell marker alkaline phosphatase (ALP) and vasa.

METHODSADSCs were isolated from adult female SD rats and cultured in vitro. The third passage of ADSCs was identified by adipogenic differentiation, osteogenic differentiation and cell surface marker detection. The ADSCs were treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA for 7 or 14 days, and the cellular expression of ALP was detected. vasa mRNA expression in ADSCs treated with 1×10(-5) mol/L RA for 7 days was detected using RT-PCR.

RESULTSThe OD value of ADSCs treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA was 0.59∓0.04, 0.27∓0.07, and 0.15∓0.03 after a 7-day treatment, and was 0.42∓0.02, 0.34∓0.01, and 0.19∓0.02 after a 14-day treatment, respectively, demonstrating significantly enhanced ALP expression in RA-treated ADSCs compared with that in the control cells (0.07∓0.01 and 0.07∓0.01 at 7 and 14 days, respectively, P<0.01). The ADSCs showed a negative vasa mRNA expression after 1×10(-5) mol/L RA treatment for 7 days.

CONCLUSIONRA-induced ADSCs express ALP, a marker of primordial germ cells, but does not express the primordial germ cell marker vasa.

Adipose Tissue ; cytology ; Adult Stem Cells ; cytology ; enzymology ; Alkaline Phosphatase ; metabolism ; Animals ; Cell Differentiation ; Cells, Cultured ; Female ; Germ Cells ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology

[Abstract]? Objective? To investigate the current situation of negative leadership behavior in hospital nursing management, analyze the relationship and influence between negative leadership behavior and nurses' sense of professional mission and patients' satisfaction, and provide theoretical basis for reducing negative leadership behavior in nursing management and improving nurses' sense of professional mission and nursing quality. Methods? From January 2017 to July 2018, 260 clinical nurses from three hospitals in Hangzhou were selected by convenience sampling method. General Information Questionnaire, Negative Leadership Scale, Professional Mission Questionnaire and Nursing Job Satisfaction Scale were used in the questionnaire survey. The negative leadership behavior in hospital nursing management and its influence on nurses' sense of professional mission and patients' satisfaction were analyzed. A total of 271 questionnaires were distributed to the nursing staff and 260 valid questionnaires were retrieved. Results? Among the 260 nurses surveyed, 22.69% encountered autocratic and selfish leadership, 30.77% encountered unfaithful leadership, 55.00% experienced constructive leadership, and the total average score of items in Negative Leadership Scale was (1.58±0.76). Autocratic and selfish leadership behavior was negatively correlated with nurses' sense of professional mission and nursing quality (P＜ 0.01), unfaithful leadership behavior was negatively correlated with nurses' sense of professional mission and nursing quality (P＜ 0.01), and constructive leadership behavior was positively correlated with nurses' sense of professional mission and nursing quality (P＜0.01). Conclusions? There are some arbitrary, selfish and unfaithful negative leadership behaviors in hospital management, which have a negative impact on nurses' sense of professional mission and patients' satisfaction. Effective measures should be taken to intervene.

Objective To establish a novel real-time quality control method for rapidly identifying the random error of sodium ion con-centration in serum using an artificial intelligence voting algorithm,and evaluate the relevant effectiveness of the model established on this basis.Methods A total of 144 754 test results of serum sodium ion rom the inpatients measured by Beckman AU5400 biochemis-try analyzer from January to May 2021 were obtained retrospectively from laboratory information system of the Department of Clinical La-boratory,Nanjing Drum Tower Hospital,and all the data were used as unbiased data for the current study.The random errors were arti-ficially introduced to generate the corresponding biased data set.Subsequently,the voting algorithm-based internal quality control model(ViQC)was established using the principles of the voting algorithm.The ViQC model and five classical PBRTQC(patient-based real-time quality control)algorithms were performed direct to each biased data.The analytical performance of the ViQC model was evaluated by using classification model criteria.The trimmed average number of patient samples until error detection(tANPed)was used to com-pare the clinical detection efficacy of the ViQC model with those of the five classical algorithms,and the error detection curves were plotted.Results Compare with all the classical algorithms,the ViQC model showed a false positive rate below 0.002 and achieved ac-curacy above 0.951 in detecting all the deviations.When the error factors were 1.5,2.5,and 3.0,the false positive rate of the ViQC model was zero.When the error factor was 2.5,its accuracy reached 0.979.Compared to the five classical PBRTQC algorithms,the ViQC model reduced the overall average tANPed by up to 34％and showed higher sensitivity for error detection.In addition,the ViQC model demonstrated the area under the ROC curve was as high as 0.989 at TEa on the test set,but the value of tANPed wasonly five.Conclusion We successfully established a real-time quality control model for the data of patients based on artificial intelligence algo-rithms,and its efficacy of clinical detection was superior to the traditional PBRTQC algorithms.

ObjectiveTo observe the clinical effectiveness and safety of Xuandi Ziyin Mixture （玄地滋阴合剂） for central precocious puberty （CPP） in girls with syndrome of yin deficiency and fire exuberance， and to analyse the effect of body mass index （BMI） on the effectiveness. MethodsA total of 236 girls with CPP of yin deficiency and fire exuberance syndrome were included， and all of them were given Xuandi Ziyin Mixture， 30 ml each time， twice a day， for a total treatment period of 6 months. Before and after treatment， children's weight， height and bone age were measured， BMI and BMI Z-score （BMI Z） and the difference between bone age and actual age were calculated； ultrasound was used to detect uterine and ovarian sizes， and to calculate uterine volume （V_uterus）， bilateral ovarian volume （V_{left ovary}， V_{right ovary}）， and bilateral maximal follicle diameters （r_{left follicle} and r_{right follicle}）； and serum sex hormones were measured， including follicle-stimulating hormone （FSH）， luteinising hormone （LH）， prolactin （PRL）， estradiol （E₂）， and testosterone （T）， and were scored for traditional Chinese medicine （TCM） syndrome. Multiple linear regression was used to analyse the influence factors of the difference between bone age and actual age， and changes in uterine volume. The children were divided into the normal weight group and the overweight/obesity group according to baseline BMI， and the bone age， the difference between bone age and actual age， V_uterus and BMI Z scores before and after treatment were compared between the two groups. ResultsFinally， 199 children entered the statistical analysis. Compared with pre-treatment， the bone age， BMI and BMI Z scores of the children increased after treatment， and the difference between bone age and actual age， TCM syndrome scores， V_uterus， V_{left ovary}， V_{right ovary}， r_{left follicle} and r_{right follicle} decreased； and the levels of serum FSH， LH， E₂， and T significantly decreased （P＜0.05 or P＜0.01）. The difference between bone age and actual age was negatively correlated with LH and V_uterus （P＜0.05）， and changes in uterine volume were positively correlated with LH （P＜0.01）. Comparing between the groups before and after treatment， the bone age， difference between bone age and actual age， and BMI Z scores of children in the normal weight group （100 cases） were significantly smaller than those in the overweight/obesity group （99 cases） （P＜0.01）. Compared with pre-treatment， the bone age of the children in both groups increased， but the difference between bone age and actual age and V_uterus were significantly smaller （P＜0.01）. Further comparison of Δ bone age and actual age difference and ΔV_uterus （Δ = post-treatment value - pre-treatment value） between the two groups showed no statistically significant difference （P＞0.05）. ConclusionsXuandi Ziyin Mixture can reduce bone age， sex hormone level， ovary and uterus size， and improve clinical symptoms in girls with yin deficiency and fire exuberance syndrome of CPP. It is also effective in overweight/obese children， and the inhibitory effect on bone age in girls with CPP is not affected by BMI， with good safety.

As known, the benefits of photothermal therapy (PTT) are greatly limited by the heat tolerance of cancer cells resulting from overexpressed heat shock proteins (HSPs). Then HSPs further trigger the formation of stress granules (SGs) that regulate protein expression and cell viability under various stress conditions. Inhibition of SG formation can sensitize tumor cells to PTT. Herein, we developed PEGylated pH (low) insertion peptide (PEG-pHLIP)-modified hollow copper sulfide nanoparticles (HCuS NPs) encapsulating the SG inhibitor ISRIB, with the phase-change material lauric acid (LA) as a gate-keeper, to construct a pH-driven and NIR photo-responsive controlled smart drug delivery system (IL@H-PP). The nanomedicine could specifically target slightly acidic tumor sites. Upon irradiation, IL@H-PP realized PTT, and the light-controlled release of ISRIB could effectively inhibit the formation of PTT-induced SG to sensitize tumor cells to PTT, thereby increasing the antitumor effect and inducing potent immunogenic cell death (ICD). Moreover, IL@H-PP could promote the production of reactive oxygen species (ROS) by tumor-associated macrophages (TAMs), repolarizing them towards the M1 phenotype and remodeling the immunosuppressive microenvironment. In vitro/vivo results revealed the potential of PTT combined with SG inhibitors, which provides a new paradigm for antitumor and anti-metastases.