To evaluate the efficacy of the prophylactic use of diclofenac in prevention of hyperamylasemia and hyperlipasemia in patients undergoing double-balloon enteroscopy (DBE).One hundred and sixteen patients undergoing peroral DBE were enrolled in the study.Total 121 procedures were performed,in 56 procedures diclofenac sodium 50 mg was administered by rectum 1 h before the peroral DBE (intervention group) and in 65 procedures no medication was given (control group).Serum amylase and lipase levels were measured before and 4 h,24 h after the procedure.At 4 h after DBE the incidence rates of hyperamylasemia and hyperlipasemia in intervention and control groups were 33.9％,38.5％ (P ＞ 0.05) and 21.4％,36.9％ (P ＞0.05),respectively.At 24 h after DBE,the incidence rates of hyperamylasemia and hypedipasemia in intervention and control groups were 19.6％,24.6％ (P ＞ 0.05) and 10.7％,15.4％ (P ＞ 0.05),respectively.Mild acute pancreatitis developed in one patient and gastrointestinal hemorrhage occurred in another patient.Hyperamylasemia and hyperlipasemia is common and transient after double-balloon enteroscopy,and rectal administration of diclofenac sodium cannot effectively reduce the incidence.

Objective To investigate the MR features of adenomyosis and its diagnostic value.Methods Forty-six patients with suspicious adenomyosis underwent preoperative ultrasound and MR exam.Inversion recovery sequence(IR)T 1-weighted images and turbo spin echo sequence(TSE)including T 1-weighted and T 2-weighted images were adopted.All patients were performed with contrast enhancement.Comparative analysis between MRI findings and pathology results was done. Results The diagnostic specificity,sensitivity and accuracy of MRI was 100%,94.74% and 97.14% respectively.The effect of MRI for diagnosis of adenomyosis was better than that of US significantly.All cases showed enlargement of uterus with regular contour.Diffuse and local thickening of junctional zone or low signal intensity lesion in outer myometrial layer was found on T 2-weighted images,sometimes bright foci observed in lesion on T 2-weighted images or on T 1-weighted images.Conclusion MRI has high value in gualitative diagnosis and localization of adenomyosis.It can be used as an important complementary method to ultrasound.

Objective To investigate influence of Qi-strengthening,blood-activating and toxin-removing therapy on plasma and colonic P-selectin in ulcerative colitis(UC) rats.Methods Trinitrobenzene sulfonic acid(TNBS) was used for the establishment of SD rat models of UC.UC rats were randomized into the model group,western medicine group(gastric gavage of suspension of Olsalazine Sodium Capsules 0.266 g?kg-1?d-1),and herbal medicine group(gastric gavage of Kuijie Fufa Recipe 20 g?kg-1?d-1).Meanwhile,a normal control group was set up.After medication for 10 and 30 days,and after drug withdrawal for 10 days,plasma P-selectin level was detected by enzyme-linked immunosorbent assay,and colonic P-selectin expression was detected by immunohistochemical assay.Results Plasma P-selectin level was increased in the model group in different time(P

Background Researches showed that triterpenoids,with a similar structure to lanosterol,has therapeutical effect on many systemic diseases,and lanosterol was determined to have a therapeutical effect on cataract recently.However,how the lanosterol plays effects on other eye diseases is still unelucidated.Understanding the distribution of lanosterol in ocular tissue is helpful for us to elucidate the relationship of lanosterol with eye diseases.Objective This study attempted to investigate the distribution of lanosterol synthase (LSS) and lanosterol in cornea,lens and retina tissue of rats and offer a basis for the targeting treatment of eye diseases.Methods Fifteen SPF male SD rats were sacrificed by excessive anesthesia to obtain the eyeballs.The relative expressions of LSS protein and gene in the cornea,lens and retina tissue of the rats were detected by Western blot and reverse transcription (RT)-PCR,respectively.Immunofluorescence staining technology was used to locate the distribution of LSS in cornea,lens and retina tissue.The contents of lanosterol in the cornea,lens and retina tissue were analyzed by liquid chromatograph mass spectrometer (LC-MS).Results No LSS protein and mRNA was expressed in the retinal tissue in normal rats.The mean relative expression of LSS protein in the lens and cornea was 0.43±0.05 and 0.25±0.03,respectively,showing a significant difference between them (t =-5.35,P＜ 0.01).The relative expression of LSS mRNA was 0.51 ±0.04 and 0.29 ±0.02 in the lens and cornea,respectively,with a stronger expression in the lens in comparison with the cornea (t =-8.34,P＜0.01).Immunofluorescence staining showed that LSS primarily located in corneal epithelial layer,stromal layer and endothelial layer as well as lens epithelial cells and shallow cortex layer and hardly expressed in retina,and no co-expression of LSS with the neuron marked by NeuN and the Müller cell marked by glutamine synthetase (GS) in retinal tissue.LC-MS analysis revealed that the contents of lanosterol in lens and cornea was (24.37 ±2.91) ng/mg and (5.31 ±0.58) ng/mg,respectively,with a significant difference between them (t =-11.13,P＜0.01).Conclusions LSS and lanosterol extensively distribute in cornea and lens of normal rats,but not in retina tissue.These results offer new strategies for the target treatment of relevant eye diseases.

There are various methods to study lens disorders,mainly in vivo and in vitro.In vitro,besides lens epithelial cells culture,lens tissue culture has been widely used,which helps to evaluate onset risk and explore pathogenesis in scientific research field.Especially in pharmacology,lens tissue culture has manifested its superiority as a screening test that helps to estimate both ocular toxic and protective effects of a certain drug and screen out appropriate drug prospectively and retrospectively.In addition,models constructed by tissue culture reveal pathophysiology of lens more intuitively and their culture conditions are much easier to control.However,methods for sampling,culture and identification were diverse.Therefore,this review aimed to retrospect the front research of lens tissue culture both at home and aboard in biological property,sampling,tissue culture,identification of condition and application.

Objective:To investigate the status of clinical nurses′ professional identity, structural empowerment and psychological empowerment, analyze the correlation between professional identity and structural empowerment and psychological empowerment, and establish a multiple stepwise regression model to discuss the dependence between professional identity and structural empowerment and psychological empowerment in clinical nurses.Methods:A total of 1 008 clinical nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University were selected as the subject by using the convenience sampling method. The General Information Questionnaire, Professional Identity Scale, Conditions of Work Effectiveness Scale, and Psychological Empowerment Scale were used to questionnaire.Results:The professional identity of nurses was at medium level (104.49±19.54), the total scores of structural and psychological empowerment of nurses were 60.09±13.49 and 42.59±7.31. Correlation analysis showed that the total score of professional identity of clinical nurses was positively correlated with the total score of structural empowerment, psychological empowerment and theirs dimensions ( r values were 0.436-0.715, P<0.01). Multivariate stepwise regression results showed that the nurse working years, health status self-assessment, formal empowerment, informal empowerment, work meaning, self-efficacy, work influence was the main influencing factors of nurses professional identity, which explained 60.5% of the total variation. Conclusions:Nursing managers should focus on the professional identity of clinical nurses, by optimizing the management organizational structure and pay attention to the perception of empowerment behavior to improve the comprehensive empowerment level, so as to enhance the professional identity of nurses.

Objective:To explore the incidence and degree of compassion fatigue in clinical nurses, and the effects of psychological empowerment on nurses' compassion fatigue level.Methods:A total of 1 005 clinical nurses were investigated with the general information, Chinese version of Professional Quality of Life Scale, Psychological Empowerment Scale. And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results:The incidence of sympathetic fatigue was 93.0%,(935/1 005), mild was 53.8%(541/1 005), medium was 22.7%(228/1 005), severe was 16.5%(166/1 005). The score of Chinese version of Professional Quality of Life Scale three dimensions: compassion satisfaction, burnout, and secondary traumatic stress of clinical nurses were 34.15±5.53, 23.96±5.10, 23.73±5.92. The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension( r values were 0.094-0.468, all P<0.05). The ordinal regression analysis indicated that job impact(odds ratio(OR) value was 1.095, 95% credible interval( CI) 0.094-0.236, P<0.01), self-efficacy( OR value was 0.920, 95% CI 0.250-0.054 , P<0.01) and job meaning( OR value was 0.820, 95% CI 0.431-0.240, P<0.01) were the independent risk factor of compassion fatigue level. Conclusions:The nurses mainly showed mild compassion fatigue, and main manifestation is secondary traumatic stress. The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue, while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue. Therefore, it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses' perception of work meaning and self-efficacy, and avoid increasing workload while paying attention to the influence of work on perception level.

Objective:To explore the early coagulation function changes of penetrating intestinal firearm injury of pig in high-altitude environments.Methods:Twenty healthy long white piglets were selected and divided into the plain group and the high-altitude group using the random number table method, with 10 pigs in each group. Pigs in the plain group were placed in a plain environment at an altitude of 800 meters, while pigs in the high-altitude group were placed in an experimental chamber simulating an altitude of 6 000 meters for 48 hours. Both groups received pistol gunshot to have firearm penetrating wounds to the abdominal intestinal tract and then returned to the plain observation room. At 0, 2, 4, 8, 12 and 24 hours after injury, coagulation in the peripheral blood and fibrinolytic indexes [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg), D-dimer (D-D), and fibrinogen degradation product (FDP)], thromboelastogram (TEG) [reaction time (R), clotting time (K), clot formation rate (α), maximum amplitude (MA) and coagulation composite index (CI) ], platelet parameters [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR)] in the two groups were detected separately.Results:The PT values at 0 and 2 hours after injury in the high-altitude group were significantly lower than those in the plain group, while they were significantly higher at 8, 12 and 24 hours than those in the plain group ( P<0.01); there was no significant difference at 4 hours between the two groups ( P>0.05). The APTT values at 0, 2 and 4 hours after injury in the high-altitude group were significantly lower than those in the plain group, while they were significantly higher at 8, 12 and 24 hours after injury than those in the plain group ( P<0.01). The TT values at 0, 2 and 4 hours after the injury in the high-altitude group were significantly lower than those in the plain group, while they were significantly higher at 12 and 24 hours after injury than those in the plain group ( P<0.01); there was no significant difference at 8 hours after injury between the two groups ( P>0.05). The Fbg, D-D and FDP values at 0, 2, 4, 8, 12 and 24 hours after injury were higher in the high-altitude group than those in the plain group ( P<0.01). The R values at 0, 2 and 4 hours after injury in the high-altitude group were significantly lower than those in the plain group, while they were significantly higher at 8, 12 and 24 hours after injury than those in the plain group ( P<0.01). The K values at 0, 2, 4 and 8 hours after injury in the high-altitude group were significantly lower than those in the plain group, while they were significantly higher at 12 and 24 hours after injury than those in the plain group ( P<0.05 or 0.01). The α angles at 0, 2 and 4 hours after injury in the high-altitude group were significantly higher than those in the plain group, while they were significantly lower at 8, 12 and 24 hours after injury than those in the plain group ( P<0.01). The MA values at 0, 2 and 4 hours after the injury in the high-altitude group were significantly higher than those in the plain group, while they were significantly lower at 8, 12 and 24 hours after injury than those in the plain group ( P<0.01). The CI values at 0, 2 and 4 hours after injury in the high-altitude group were significantly higher than those in the plain group, while they were significantly lower at 8, 12 and 24 hours after injury than those in the plain group ( P<0.01). The PLT values at 0, 2, 4 and 8 hours after injury in the high-altitude group were significantly higher than those in the plain group, while they were significantly lower at 12 and 24 hours after injury than those in the plain group ( P<0.05 or 0.01). The MPV values at 0, 2, 4, 8, 12 and 24 hours after injury in the high-altitude group were significantly higher than those in the plain group ( P<0.01). The PDW values at 2, 4, 8, 12 and 24 hours after injury in the high-altitude group were significantly higher than those in the plain group ( P<0.05 or 0.01), while there was no significant difference in PDW at 0 hour after injury between the two groups ( P>0.05). The P-LCR values at 0, 2, 4, 8, 12 and 24 hours after injury in the high-altitude group were all significantly higher than those in the plain group ( P<0.01). Conclusion:Compared with the plain environments, pig intestinal firearm penetrating injury in the high-altitude environments is more prone to early hypercoagulable state accompanied by mild hyperfibrinolysis, and faster to reach a hypocoagulable state accompanied by obvious hyperfibrinolysis.

Objective: To understand the status quo and correlation between problem solving ability and positive mental capital of nursing undergraduates. Methods: A total of 238 nursing undergraduate were investigated with the Problem Solving Scale and the Positive Mental Capital Scale. Results: In terms of each dimension in Problem Solving Ability Inventory, the scores from high to low respectively were rational problem solving, positive problem orientation, avoidance style, negative problem orientation, impulsivity/carelessness style, the total score of positive mental capital was 125.24±17.71. Multivariate stepwise regression analysis showed that self-efficacy, hope explained for 29.4% of positive problem orientation variation and 15.4% of explaining rational problem solving variation. Resiliency, self-efficacy explain for 35.8% of the negative problem orientation variation. Hoped, resiliency explained for 9% of impulsive/carelessness style variation and 21.8% of avoidance style variation. Conclusions The problem solving ability of nursing undergraduates was weak, which was closely related to positive psychological capital, and can improve the overall problem solving ability of nursing students by improving their self-efficacy, hope and resiliency.

Objective: To explore the persistent viral response rate (SVR) in patients with refractory chronic hepatitis C after interferon (IFN) (peginterferon 360 μg qw) and ribavirin (PR) therapy failure. The SVR of patients with refractory chronic hepatitis C was improved by PR combined with direct antiviral agents (DAA) and proper extension of the course of therapy was applied. Methods: Seventeen cases of refractory chronic hepatitis C after IFN(peginterferon 360 μg qw) and ribavirin therapy failure were given PR combined with DAA treatment. The side effects were observed and corresponding adjustments were made on drug dosage, and SVR was recorded. Results: The 17 cases completed the whole course of treatment with PR combined with DAA for 24 weeks. All the 17 patients obtained rapid viralogical response (RVR) and SVR. After treatment, the SVR rate was 100% in patients including those with virologic relapse, retreated or previously non-responsive patients with refractory chronic hepatitis C. The adverse reaction of PR combined with DAA 24 weeks was generally mild. Conclusions The use of PR combined with DAA re-treatment in patients with refractory chronic hepatitis C can achieve SVR and shorten the treatment time. PR combined with DAA re-therapy is one of effective treatments to improve the rate of sustained viral response in patients with refractory chronic hepatitis C.