Objective To investigate the intra-and postoperative course of patients undergoing laparoscopic liver resections under intermittent total pedicle occlusion (IPO),hemihepatic vascular occlusion (HVO),and selective vascular occlusion(SVO).Methods Retrospective analysis the data of 41 cases of laparoscopic liver resection were conducted in three groups of patients under different occlusion methods,including 15 cases of intermittent total pedicle occlusion (IPO),12 cases of hemihepatic vascular occlusion (HVO) and 14 cases of selective vascular occlusion (SVO).Intraoperation blood loss,operation time,conversion to open operation,changes in postoperative liver function,hospital stays and complications were compared among the three methods.Results There was no operative death in any of the 41 patients.There was no conversion to open surgery.Generally,there was no significant difference among the three groups in blood loss,clamping time or operative time.Ten patients had postoperative complication and all were cured.The effect on liver function for Gro-HVO and Gro-SVO was significantly less severe than that for Gro-IPO (P ＜ 0.05) after operation.Conclusions Both HVO and SVO are feasible and safe in laparoscopic hepatectomy(LH),and have advantage in reducing liver remnant ischemia injury and modality rate over IPO.HVO is easy to do for left lateral lobe or resection of the left half of the liver.SVO is suitable for right lobe resection.

Objective To study the relationship between psychological resilience and occupational stress of nurses in disinfec-tion supply center. Method A cluster sampling method was used to investigate 387 nurses in the supply and demand center by using the Chinese version of the Connor-Davidson scale (Connor-Davidson resilience, CD-RISC) and the nurse job stressors scale. Results In the disinfection supply center, the nurses' mental resilience score was (76.72±13.67), at the middle level. The total score on occupa-tion pressure was (72.84±12.19), at the moderate stress level. Pearson correlation analysis showed that the sterilization and supply cen-ter nurses' mental resilience score, together with the dimensions were positively correlated with occupation pressure. The mental re-silience and occupation pressure were positively correlated (P<0.05). Conclusions The psychological toughness and occupational stress of nurses in the sterilization and supply center are in the middle level. The nursing managers can promote the sustainable develop-ment of the nurses' psychological toughness through the stress management training and the nursing profession quality improvement.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups: control group (n=56) treated with conventional therapy, and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells (WBC) counts, prothrombin time (PT), serum creatinine (SCr), alanine aminotransferase (ALT), serum albumin and PaO(2) were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced (P<0.05), but the level of serum albumin was significantly increased (P<0.05) at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 (P<0.01) after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased (P<0.01). The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated.A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups:control group (n=56) treated with conventional therapy,and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L.White blood cells (WBC) counts,prothrombin time (PT),serum creatinine (SCr),alanine aminotransferase (ALT),serum albumin and PaO2 were measured before and at the day 1,3,5,7 and 14 after treatment.The incidence of gastrointestinal dysfunction,the incidence of MODS,hospital stay and the mortality were also observed and compared.After intensive insulin therapy,the WBC counts,SCr,ALT and PT were significantly reduced (P＜0.05),but the level of serum albumin was significantly increased (P＜0.05) at the day 3,5,7 and 14.In the meantime,the PaO2 was significantly elevated at the day 3,5 and 7 (P＜0.01) after intensive insulin therapy.The incidence of gastrointestinal dysfunction,the incidence of MODS,the length of hospital stay and the mortality were markedly decreased (P＜0.01).The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

OBJECTIVE： To determine and compare the contents of catalpol and aucubin in different parts （root， stem， leaf and flower） of wild Centranthera grandiflora， and to provide reference for the selection of medicinal parts and source development. METHODS： HPLC method was used to determine the contents of catalpol and aucubin in root， stem， leaf and flower of wild C. grandiflora， and the contents of different parts were analyzed comparatively. The determination of catalpol was performed on Agilent TC-C18 column with mobile phase consisted of methanol-0.1％ phosphoric acid （1 ∶ 99， V/V） at the flow rate of 1 mL/min； the detection wavelength was set at 210 nm， and sample size was 20 μL. The column temperature was 35 ℃； the determination of aucubin was performed on SPHERI-5RP-C18 column with mobile phase consisted of acetonitrile-water （3 ∶ 97， V/V） at the flow rate of 1 mL/min； the detection wavelength was set at 205 nm， and sample size was 20 μL； the column temperature was 25 ℃. RESULTS： The linear range of catalpol and aucubin were 0.061 5-3.321 and 0.000 36-0.216 mg/mL （all r＝0.999 9）. The limits of detection were 0.016 and 0.007 μg/mL. The limits of quantitation were 0.052 and 0.023 μg/mL. RSDs of precision， stability （24 h） and reproducibility tests were all lower than 2.00％ （n＝6）. The average recoveries were 99.34％ and 99.61％， and RSDs were 1.06％ and 1.12％， respectively （n＝6）. The average content of catalpol in root， stem， leaf and flower wild C. grandiflora were 1.609， 3.030， 11.095 and 1.921 mg/g， respectively. The contents of aucubin in different parts were 0.441， 0.020， 0.005 and 0.006 mg/g，respectively. CONCLUSIONS：The established HPLC method meets the requirements of quantitative analysis. Catalpol is mainly distributed in the leaves of wild C. grandiflora， and aucubin is mainly distributed in the roots of wild C. grandiflora. The experimental conclusion provides a reference for the reasonable selection of different medicinal parts as raw materials to develop medicine with different efficacy.