Objective To characterize pancreatic perfusion in swines with experimental chronic pancreatitis(CP)by dynamic contrast-enhanced MRI and to correlate it with the severity of CP.Methods Twenty-two swines were randomly selected and made CP by ligation of main pancreatic duct.Six healthy swines served as control.MR perfusion study with dynamic contrast-enhanced MRl was carried out on the swines under anesthesia.The animals were euthanized after MR perfusion exam.The swines were divided into 4 groups according to the histological results of pancreas:normal group,group of CP of grade 1,group of CP of grade 2,and group of CP of grade 3.The maximum perfusion slope rate,the time-to-peak value and the maximum enhancement rate was compared between the groups using variance analysis,and the relationship between each perfusion parameters and severity of CP was made by correlative analysis.Results Twenty-one swines underwent MR perfusion study,including 7 swines in normal group,7 in group of grade 1 CP,3 in group of grade 2 CP,and 4 in group of grade 3 CP.On signal intensity time curve(SI-T)derived from MR perfusion weighted imaging,the m~imum slope rate was(10.88±1.20)%,(10.59±1.02)%,(6.67±1.31)%,and(5.48±1.97)%for normal swines,swines with grade 1 CP,swines with grade 2 CP and swines with grade 3 CP,respectively(F=20.51,P＜0.05).The time-to-peak value was(13.82±3.09)s,(12.31±5.52)s,(20.55±3.79)s and(37.26±14.56)s respectively(F=10.68,P＜0.05).The maximal signal enhancement rate was(62.95±20.20)%,(60.44±20.00)%,(46.33±22.70)%,and(67.65±32.66)%,respectively(F=0.53,P＞0.05).The highest slope value(r=-0.72,P＜0.05)and the time-to-peak(r=0.54,P＜0.05)of the SI-T curve were correlated to the severity of CP,respectively.However there was no linear correlation between the maximal signal enhancement rate and the severity of CP.Conclusion MR perfasion weighted imaging has a potential to diagnose and to grade experimental chronic pancreatitis.

Objective To evaluate the effect of surgical therapy for hepatolithiasis by hepatectomy and choledochofiberscopy. Method We retrospectively analyzed hepatolithiasis patients in our hospital during the past 5 years, comparing the therapeutic effect of different surgical modality. Data were analyzed by chi-square test. Result A total of 469 patients underwent surgical treatment, 412(87.85%) cases were followed up for an average of 3 years and 6 months. The residual calculus rate was 5. 14% and 14. 81% (x2 =9.32,P

ObjectiveTo evaluate the influence of electrotome on permanent and temporary cardiac pacemaker in laparoscopic cholecystectomy ( LC),and the application of cardiac pacemaker to the cases of cholecystolithiasis combined with bradyarrhythmia.MethodsClinical data of 215 patients with permanent or temporary cardiac pacemaker who underwent were studied for the preoperative and postoperative variation of pacemaker function,and for the influence of electricity coagulation during the operation on cardiac pacemaker function.ResultsLC was successfully completed in all 215 patients.The function of cardiac pacemaker was not obviously interfered during the operation,and the parameters of cardiac pacemaker did not remarkably change after the operation.ConclusionCardiac pacemaker is slightly interfered when electrotome and electrocoagulation were used in LC; LC is feasible and safe for patients with bradyarrhythmia by placement of cardiac pacemaker.

Objective To study the effect of expression of myoglobin which mediated by adenovirus,on ATP value of liver and the protective effect on liver ischemia reperfusion injury.Methods Adenovirus carrying CMV promoter sequences linked to the human myoglobin gene(AdCMVMyo) were transfected into rats liver. Then myoglobin, hepatic ATP levels and liver function were evaluated. Results Myoglobin expression was verified in rat livers after AdCMVMyo transfection. The ATP levels in rat livers 72 hours after AdCMVMyo transfection were significantly higher than that in control group(P

OBJECTIVE: To explore the technique and effect of liver hanging maneuver in anterior approach for isolated complete liver caudate lobectomy. METHODS: We recruited 17 patients with liver caudate lobe tumor (13 primary hepatocellular carcinoma, 3 cholangiocarcinoma and 1 liver metastasis from colorectal cancer). Isolated complete caudate lobectomy with liver hanging maneuver was performed in 17 patients. RESULTS: All 17 patients were successfully received the above-mentioned operation. The operative time was 166-427 (211.5 ± 20.1) min and the intraoperative blood loss was 372-1 208 (472.7 ± 83.6) mL. There was no operative death. The survival rates of follow up for 1, 3 and 5 years were 76.5%, 52.9% and 23.5%, respectively. CONCLUSION Liver hanging maneuver for isolated complete resection of the caudate lobe is an ideal approach for liver neoplasms resection.
Blood Loss, Surgical ; Carcinoma, Hepatocellular ; surgery ; Cholangiocarcinoma ; surgery ; Colorectal Neoplasms ; pathology ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; secondary ; surgery ; Survival Rate

Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.

Objective To explore the prevalent challenges in the construction and operation of SPD(Supply,Process-ing,and Distribution)projects for medical consumables and to propose corresponding strategies,thereby offering hospital supply managers insights for references.Methods Based on the questionnaire survey,the scope of difficulties was assessed across 23 hospitals.scores of each difficult point were calculated with descriptive statistics methods according to various stages,and the causes were analyzed.Results The overall scores of the survey ranged from 50 to 77 points,with the highest in each category being system interface docking(77 points),system stability(73 points),inventory carry-over(61 points),and the professional capability of SPD service provider(66 points).Conclusion In the construction and operation of SPD projects,it is essential to select an SPD model and service provider that aligns with the hospital's own characteristics.Establishing robust assessment mechanisms for SPD service providers and personnel training,as well as a comprehensive system audit and testing framework,can ensure system stability.Additionally,effective work assignment and performance evaluation of SPD personnel should be well-man-aged.

Objective To investigate the mechanism of fisetin inhibiting the activation of microglia NOD-like receptor family protein 3(NLRP3)inflammasome in microglia and alleviating cognitive impairment after sepsis.Methods C57BL/6 mice were used to establish the sepsis model by cecal ligation and puncture.Mice were divided into four groups:the sham group,the sepsis group,the sepsis+caspase-1 knockout group(sepsis+Cas-1-/-group)and the sepsis+fisetin group.Evans blue was used to detect the permeability of blood-brain barrier(BBB).Morris water maze was used to evaluate the cognitive function of mice.Western blot assay and immunofluorescence double staining were used to detect the expression of NLRP3 inflammasome-related proteins including caspase-1,N-terminal fragment of the GSDMD(GSDMD-N),interleukin(IL)-1β,IL-18 and mitophagy-related proteins(Pink1,Parkin and LC3-Ⅱ)in brain tissue and microglia.Results Compared with the sham group,expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly increased in the sepsis group(P＜0.05).Compared with the sepsis group,expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly decreased in the sepsis+Cas-1-/-group(P＜0.05).The expression levels of Pink1,Parkin and LC3-Ⅱ were significantly higher in the sepsis+fisetin group than those of the sepsis group(P＜0.05),and expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly lower(P＜0.05).After fisetin intervention,the permeability of BBB was decreased and the cognitive impairment(decreased escape latency and increased frequencies of crossing the platform)was alleviated in the sepsis+fisetin group compared with those of the sepsis group(P＜0.05).Conclusion Fisetin may alleviate central inflammation and cognitive impairment after sepsis by inhibiting the activation of microglial NLRP3 inflammasome through activating mitophagy.

Objective:To explore the current status of nursing practice in the prevention and control of ICU catheter-associated bloodstream infection (CLABSI) in domestic ClassⅢ Grade A hospitals, evaluate the weaknesses in nursing practice, and discuss the common problems.Methods:On March 1, 2017, the ICUs of totally 55 hospitals from 16 Provinces /Municipalities /Autonomous Regions nationwide where the members of the Hospital Infection Committee under the Chinese Nursing Association worked were selected by convenient sampling and investigated with a self-designedquestionnaire on implementation of best practices for catheter-related bloodstream infections. Before the survey, the investigators participating in the survey were trained. Totally 134 questionnaires were recovered, accounting for a recovery rate of 100%. Totally 117 of them were valid, with a valid recovery rate of 87%.Results:In the 117 ICU, totally 71 (60.68%) ICUs filled in the incidence of CLABSI, and 18 (15.38%) data came from their departments. In the central venous catheterization (CVC) process, 65 (55.56%) ICUs were supervised; 109 (93.16%) ICUs used special puncture bags; 74 (63.25%) ICUs used sterile surgical gowns; 26 (22.22 %) ICUs used sterile towels to cover the whole body; and 13 (11.11%) ICUs used Statlock to fix the catheter. In the CVC maintenance process, the frequency of transparent dressing replacement was within 7 days in 106 (90.60%) ICUs; the frequency of gauze replacement was 1 to 2 days in 44 (37.61%) ICUs; 22 (18.80%) ICUs used disposable prefilled liquid flushing tube; 103 (88.03%) ICUs replaced infusion sets every 24 h during continuous transfusion; and 13 (11.11%) ICUs adopted chlorhexidine for sponge bath. 97 (82.91%) ICUs did not have procedures for using infusion connectors, and the nurses of 28 (23.93%) ICUs did not know the type of connectors used.Conclusions:At present, the clinical nursing measures to prevent and control CLABSI are quite different. It is recommended to standardize guidelines, conduct high-quality research, and strengthen personnel training.

Objective:To investigate the protective effect and possible mechanism of sulforaphane (SFN) on acute liver injury in mice induced by diquat (DQ) poisoning.Methods:Forty-eight male C57BL/6 mice were divided into Control group, DQ model group (DQ group), SFN intervention group (DQ+SFN group), and SFN control group (SFN group) using a random number table method, with 12 mice in each group. Acute liver injury mice model was established by one-time intraperitoneal injection of 1 mL of 40 mg/kg DQ solution at once. SFN group was injected with 1 mL of ddH 2O. After 4 hours of molding, 0.5 mL of 5 mg/kg SFN solution was injected into the peritoneal cavity of the DQ+SFN group and SFN group, once daily for 7 consecutive days. DQ group and Control group were injected with an equal amount of ddH 2O. Then, the mice were euthanized to collect liver tissue and blood samples, and the levels of plasma biomarkers alanine aminotransferase (ALT) and aspartate aminotransferase (AST), as well as oxidative stress indicators such as superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in liver tissue were measured. The changes of liver structure were observed under transmission electron microscopy. The apoptosis and reactive oxygen species (ROS) level in liver tissue were observed under fluorescence microscope. Western blotting was used to detect the protein expressions of nuclear factor E2-related factor 2 (Nrf2), hemeoxygenase-1 (HO-1), Kelch-like ECH-associated protein 1 (Keap1), and cleaved caspase-9 in liver tissue. Results:Compared with the Control group, the liver mitochondria in the DQ group showed severe swelling, partial dissolution of the matrix, and cristae rupture and loss; the levels of plasma AST and ALT significantly increased, the MDA content in the liver increased, the activities of SOD and GSH decreased, the level of ROS significantly increased, the number of apoptotic cells in the liver significantly increased, the protein expressions of Nrf2 and HO-1 significantly decreased, and the protein expressions of Keap1 and cleaved caspase-9 significantly increased. Compared with the DQ group, the mitochondrial damage in the DQ+SFN group was reduced, the levels of plasma AST and ALT were significantly reduced [ALT (U/L): 58.22±4.39 vs. 79.94±3.32, AST (U/L): 177.64±8.40 vs. 219.62±11.60, both P < 0.01], the liver MDA content decreased, and the activities of SOD and GSH increased [MDA (μmol/g: 5.63±0.18 vs. 5.96±0.29, SOD (kU/g): 102.05±4.01 vs. 84.34±5.34, GSH (mmol/g): 16.32±1.40 vs. 13.12±1.84, all P < 0.05], the production of ROS in liver tissue was significantly reduced [ROS (fluorescence intensity): 115.90±10.89 vs. 190.70±10.16, P < 0.05], and apoptotic cells were significantly reduced (cell apoptosis index: 4.39±1.00 vs. 10.71±0.56, P < 0.01), the protein expressions of Nrf2 and HO-1 were significantly increased, while the protein expressions of Keap1 and cleaved caspase-9 were significantly decreased (Nrf2/β-actin: 1.15±0.04 vs. 0.93±0.05, HO-1/β-actin: 1.75±0.12 vs. 0.78±0.04, Keap1/β-actin: 1.00±0.14 vs. 1.28±0.13, cleaved caspase-9/β-actin: 1.31±0.12 vs. 1.81±0.09, all P < 0.05). However, there was no statistically significant difference in various indicators between the SFN group and the Control group. Conclusion:SFN can activate the Keap1/Nrf2 signaling pathway to alleviate DQ induced acute liver injury in mice.