Amitriptyline ; therapeutic use ; Child ; Constipation ; drug therapy ; Dyspepsia ; drug therapy ; Gastrointestinal Agents ; therapeutic use ; Gastrointestinal Diseases ; drug therapy ; therapy ; Humans ; Hypnosis ; methods ; Irritable Bowel Syndrome ; therapy ; Polyethylene Glycols ; therapeutic use ; Randomized Controlled Trials as Topic ; Research Design

Objective To study the prognosis of gastroesophageal reflux disease ( GERD) in children, and explore the factors which impacts on the prognosis of GERD. Methods One hundred and thirteen children with GERD were enrolled on the basis of positive result of 24-hour pH-monitoring between January 2007 and November 2011. The number of patients who were followed up was 87,and the parents of children were contacted with the telephone. The prognosis was evaluated by comparing the degree of patients′symptom relief,and the cumulative symptom relief rate was calculated by Kaplan-meier product limit method. The univariate Log-rank test and the COX proportional hazardmodel multivariate analysis were applied to detect the factors impacting on the prognosis,including age,gender,the regularity of treatment,reflux index,and Boix-Ochoa standard score,with esophageal hiatal hernia or without,receiving surgical treatment or not,the diet and lifestyle improved or not,receiving anti-acid treatment or not,as well as with allergies his-tory or without. Results At last,76 out of 87 children had symptom relieved. Survival curve showed the cumulative symptom relief rate at different time points,the median cumulative symptom relief rate reached 6 months,the final relief rate was close to 90. 0%,and the continuous treatment time was 44 months. The study showed that 14. 9% (13/87 ca-ses) of children′s growth and development were affected and the life and learning in 16. 1% (14/87 cases) of children were impacted. Age (P=0. 012,Wald=6. 376) and the regularity of treatment (P=0. 000,Wald=13. 059) were the risk factors in the prognosis of GERD. Conclusions Age and the treatment regularity were the factors in the prognosis. The children aged more than 1-year old have poor prognosis compared with those less than 1-year old,and the irregular treatment is the risk factor in the prognosis.

Background:Pyruvate kinase M2( PKM2 ),which is highly expressed in cancer cells,plays an important role in cancer cell growth and aerobic glycolysis and is a promising target for cancer therapy. Aims:To investigate the effect of silencing PKM2 by siRNA on proliferation,apoptosis,migration,invasion and glycolysis of gastric cancer cell line SGC-7901 cells. Methods:SGC-7901 cells were divided into three groups:non-transfectd SGC-7901 cells,SGC-7901 cells transfected with empty plasmid and SCG-7901 cellls transfected with PKM2 siRNA. Expression of PKM2 was detected by fluorescent quantitative PCR and Western blotting at mRNA and protein levels. Intracellular expression and distribution of PKM2 was determined by immunofluorescence. CCK-8 assay,flow cytometry,migration and invasion experiment were used to assess cell proliferation,apoptosis,migration and invasion,respectively. Western blotting was used to determine the expression of glucose transporter-1( Glut-1)and lactate dehydrogenase A( LDHA). Spectrophotometry was used to detect levels of extracellular glucose and lactic acid and intracellular lactate dehydrogenase( LDH). Results:Compared with non-transfected group and negative control( empty plasmid )group,PKM2 mRNA and protein expressions were significantly decreased in PKM2 siRNA plasmid transfected group(P<0. 05). Intracellular expression of PKM2 was markedly decreased in PKM2 siRNA cells. After transfected with PKM2 siRNA plasmid,cell proliferation,migration and invasion were significantly inhibited,and cell apoptosis was increased significantly( P<0. 05 ). Expressions of Glut-1 and LDHA were down-regulated in PKM2 silenced cells( P <0. 05 ). Glucose uptake,lactic acid production and LDH activities were significantly decreased in PKM2 silenced cells(P<0. 05). Conclusions:RNA interference targeting PKM2 gene inhibits PKM2 expression in human gastric adenocarcinoma cell line SGC-7901 cells,thereby inhibits cell proliferation and glycolysis.

Objective To investigate the etiology and clinical characteristics of chronic pancreatitis (CP) in children,so as to improve its diagnosis and treatment.Methods The etiology,clinical characteristics,radiological records and therapy were retrospectively analyzed in children with CP who were admitted to Beijing Children's Hospital Affiliated to Capital Medical University from July 2006 to May 2014.Results A total of 29 medical records of children with CP,including 19 male and 10 female,with a mean age of (8.5 ± 3.7) years,and the youngest case was a 2-year-old child,the oldest case was a 15-year-and-2-month-old child.The main etiological factor was idiopathic pancreatitis (51.7％,15/29 cases),and 9 cases were caused by anatomical anomalies (31.0％,9/29 cases).The main symptoms included abdominal pain (89.7％,26/29 cases),malnutrition (48.3％,14/29 cases),nausea and vomiting (31.0％,9/29 cases),and chest distress and dyspnea (17.2％,5/29 cases).The serum amylase level in 18 cases (62.1％) increased.The positive diagnostic rate of transabdominal ultrasound was 96.6％ (28/29 cases),and dilations of pancreatic ducts or/and intraductal stones were 82.8％ (24/29 cases).The positive rate by magnetic resonance cholangio-pancreatography (MRCP) for morphological changes in pancreas was 88.5％ (23/26 cases),and dilations of the pancreatic ducts were 80.8％ (21/26 cases).A total of 10 endoscopic retrograde cholangio-pancreatography (ERCP) procedures were performed on 6 children,and pancreatic ductal stenosis or dilations were detected in them.All the patients were treated conservatively at first,and then 7 cases of them had surgical therapy (oledochojejunostomy,choledochoduodenostomy,choledochocystectomy,etc.),aud 6 cases had stent insertion by ERCP.Conclusions The main causes of CP in children are idiopathic and anatomical anomaly,and its diagnosis is based on symptoms and imaging changes;surgical or endoscopic therapy can be used if internal therapy is not effective.

Objective:To evaluate the short-type single balloon enteroscope (SBE) to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anastomosis.Methods:Data of 10 patients with Roux-en-Y anastomosis who received short-type SBE assisting ERCP (14 times of ERCP, the short-type SBE group) from May 2019 to September 2019 and 55 patients who received conventional SBE assisting ERCP (87 times of ERCP, the conventional SBE group) from March 2016 to April 2019 were collected in Nanjing Drum Tower Hospital. Success rates and mean time of reaching the blind loop, diagnosis and treatment success rates, procedure time and complication incidence in the two groups were compared.Results:The mean time to reach the blind loop was significantly shorter in short-type SBE group than that in the conventional SBE group (17.1 min VS 23.4 min, P = 0.04). There were no significant differences in success rates of reaching the blind loop[100.0%(14/14) VS 95.4%(83/87)], the success rates of diagnosis and treatment[both 100.0% (14/14) VS 100.0% (83/83)], the mean procedure time (62.6 min VS 64.3 min) or complication incidence [21.4%(3/14) VS 16.1% (14/83) ] between the two groups (all P>0.05). Conclusion:ERCP assisted by either type of SBE is safe and effective in patients with Roux-en-Y anastomosis. However, short-type SBE is faster to reach the blind loop because of its unique design and easier manipulation.

Objective: To investigate the causal relationship between antioxidant nutrients and pregnancy complications, so as to provide the reference for the prevention and treatment of pregnancy complications. Methods: Data of seven antioxidant nutrients including vitamin A, vitamin C, vitamin E, selenium, zinc, copper and iron were collected from genome-wide association study (GWAS) Catalog database, and data of four pregnancy complications including gestational diabetes mellitus, pre-eclampsia, spontaneous abortion and preterm birth were collected from the Finland database. Single nucleotide polymorphism (SNP) data were collected, and 27 SNPS strongly correlated with seven antioxidant nutrients were selected as instrumental variables. Mendelian randomization (MR) analyses were performed using the inverse-variance weighted (IVW) method with seven antioxidant nutrients as exposures factors and four pregnancy complications as outcome variables. The heterogeneity was assessed using the Cochran's Q test, the horizontal pleiotropy was assessed using the MR-PRESSO test and MR-Egger regression, and the robustness of the results was verified with the leave-one-out. Results: Cochran's Q test showed heterogeneity of MR results between vitamin C and gestational diabetes mellitus, preeclampsia and preterm birth, between vitamin E and iron and gestational diabetes (all P<0.05), and a random effect model was employed. There was no heterogeneity in other results (all P>0.05), and a fixed effect model was employed. MR analysis results showed that there was no causal association between seven antioxidant nutrients and the risk of four pregnancy complications (all P>0.05). MR-PRESSO test and the MR-Egger regression identified no horizontal pleiotropy of instrumental variables (both P>0.05). Conclusion This study did not find genetically predicted associations of antioxidant nutrients with pregnancy complications.

Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for children with pancreaticobiliary diseases. Methods Data of children under 14 years old who have underwent ERCP in Nanjing Drum Tower Hospital between September 2007 and August 2016 were reviewed for completion, complications and therapeutic methods. Results A total of 41 children underwent 68 ERCP, including 6(8. 8%) diagnostic and 62(91. 2%) therapeutic procedures. All procedures were performed under deep sedation. Cannulation failed in only 1 child with anomalous junction of pancreaticobiliary duct. The procedure success rate was 98. 5%( 67/68 ) . There were 8 adverse events, including 7 mild post?ERCP pancreatitis and 1 fever. Incidence of adverse event was 11. 8%( 8/68) . There was no such severe adverse event as bleeding, perforation, death, or other anesthesia related adverse event. Thirty?two children ( 78. 0%) had follow?up, ranging from 2 month to 6 years. Children followed lived well with no long?term adverse event. Conclusion ERCP is an effective and safe procedure for the diagnosis and treatment of pancreaticobiliary diseases in children.

Objective:To summarize the research progress of domestic nurses′ turnover intentions in the past ten years, and to provide references for related research on improving nurses′ turnover intentions.Methods:In May 2021, the documents related to nurses′ resignation intentions were retrieved in China National Knowledge Infrastructure (CNKI), Wanfang and VIP database and Citespace5.7.R5 software was used to perform keyword visualization analysis to form keyword clustering graphs and tables, emergent words, and corresponding time zones figure, the current research status and hot trends of nurses′ turnover intentions were analyzed.Results:A total of 2 029 valid documents were retrieved, the number of publications reached the highest peak in 2019. Among them, "nurse", "willingness to leave", "job satisfaction", "turnover intention" and "influencing factors" were the top 5 hot keywords and 23 emergent words were generated; research directions mainly included influencing factors and research objects and workplace related topics.Conclusions:Managers should actively play a leadership role to reduce nurses′ turnover intention through various effective intervention studies.

Objective To observe the early clinical outcomes of iliotibial band with Gerdy's tubercle transplantation for irreparable rotator cuff tears (IRCT).Methods A total of 16 patients with IRCT who underwent iliotibial band with Gerdy's tubercle transplantation from June 2014 to June 2015 and with a minimum follow-up of 2 years were retrospectively analyzed.There were 4 male and 12 female with a mean age of 56.1±6.6 years old (range 44-67 years old).The X-ray and MRI were used to evaluate the improvement of acromiohumeral interval (AHI),rotator cuff healing and final outcome of bone graft postoperatively.Functional outcomes were assessed by visual analogue scale (VAS),American Shoulder and Elbow Surgeon (ASES) and Constant-Murley score.Results The average follow-up duration was 25.3±1.5 months (range 24-48 months).At the final follow-up,the forward flexion,external rotation and internal rotation were 159.37°±8.51°,35.31°±8.26° and 11.00°±2.52°,respectively.There was statistically significant difference between preoperative and postoperative joint range of motion (P ＜ 0.05).At the 3 months postoperatively,all patients had complete bone union between the Gerdy's tubercle and the greater tubercle.However,at the final followup,partial or complete bone absorption was observed in 6 patients.Twelve patients had complete rotator cuff healing,and 4 patients had partial healing.No patient had rotator cuff retear.The AHI increased significantly from 3.63±1.25 mm preoperatively to 8.37± 1.02 mm postoperatively (P ＜ 0.05).The postoperative VAS,ASES and Constant-Murley score were 1.06±0.93,81.75±6.80 and 77.12± 6.72,respectively.The differences between preoperative and postoperative VAS,ASES and Constant-Murley score were statistically significant (P ＜ 0.05).There was significant difference in postoperative VAS between bone absorption group and non-absorption group (P ＜ 0.05),while no significant difference was found in ASES or Constant-Murley score (P ＞ 0.05).Conclusion All patients had complete or partial rotator cuff healing.However,37.5％ of the patients had bone absorption and obtained a worse VAS score.The iliotibial band with Gerdy's tubercle transplantation for IRCT could significantly restore the joint function at 2 years postoperatively.

Objective:To compare the histopathological features and treatment efficacy of different methods for metachronous early gastric cancer (MEGC) in the remnant stomach.Methods:A total of 66 patients [38 endoscopic submucosal dissection (ESD) and 28 gastrectomy] with MEGC in the remnant stomach from January 2014 to December 2020 in Drum Tower Hospital were divided into the ESD group and the gastrectomy group. The baseline characteristics, histopathological features, treatment efficacy, and cost differences of the two groups were analyzed.Results:The MEGC in the remnant stomach mostly occurred in elderly male patients, with the mean age of 69.7±8.5 years. The mean interval of the occurrence of MEGC in the remnant stomach was 6 years. As for the tumor location, the gastric body (31.6%) was the main location in the ESD group and gastric cardia (53.6%) in the gastrectomy group with significant difference ( χ2=11.07, P=0.026). The mean operation time, hospital stay, postoperative fasting time, and total treatment cost were 80.0 min, 6.0 d, 1.5 d, ￥19 436 in the ESD group and 215.0 min, 19.0 d, 6.5 d, and ￥68 665 in the gastrectomy group, respectively, with significant differences between the two groups ( P<0.05). The overall survival rate during follow-up was 76.3% in the ESD group and 71.4% in the gastrectomy group with no significant difference between the two groups ( χ2=0.736, P=0.778). In terms of postoperative complications, the incidences of bleeding and infection were 7.9% and 5.3% in the ESD group, and those of obstruction and infection were both 14.3% in the gastrectomy group. There was significant difference in the incidences of postoperative obstruction between the two groups ( P<0.05). Conclusion:ESD is safe and effective for MEGC in the remnant stomach and is better than gastrectomy in terms of the treatment cost and operation time, but the long-term efficacy still needs to be validated by large-scale prospective studies.