Objective To investigate the utilization of damage control surgery (DCS) in treatment of the severe abdominal traumas.Methods The clinical data of 56 patients with severe abdominal traumas treated by DCS (Emergency operation,fluid resuscitation and definitive operation were used gradually.)from January 2011 to January 2013 in Department of General Surgery,Taizhou People's Hospital were retrospectively analyzed.Results Of the 56 patients,52 were cured and discharged from hospital,the clinical curative rate was 92.9％; 4 patients dead.Conclusions Abdominal traumas under going operations by applying the damage control surgery significantly increased the clinical curative rate.

Objective To investigate the role of intestinal fatty acid binding protein (IFABP) and blood procalcitonin (PCT) in diagnosis of traumatic Intestinal rupture in early stage.Methods The clinical data of 58 patients with abdominal injuries admitted from May 2012 to April 2016 were retrospectively analyzed.All 58 patients were divided into intestinal rupture group (n =21) and nonintestinal rupture group (n =37).The concentrations of IFABP and PCT were detected,analyzed and compared between two groups at different intervals.Results The IFABP and PCT in intestinal rupture group were significantly higher than those in non-intestinal rupture group.The IFABP and PCT in intestinal rupture group significantly decreased after operations.There were significantly differences in IFABP and PCT between two groups at admission,4 hours after admission,preoperative period,and 24 hours after operation.However,these differences disappeared at 72 hours after operation.At the same time,the accuracy rate 92.4％,sensitivity 96.3％,specificity 72.8％ found in combination of these two biomarkers were significantly higher than those of IFABP and PCT measured separately.Conclusions The combination of IFABP and PCT detection can be used as an indicator for the diagnosis of traumatic intestinal rupture in the early stage.

Objective:The operative approach and steps of laparoscopic right hemicolon cancer radical resection have been standardlized and professional consensus has been reached. However, some detailed issues such as the handling of Henle's trunk and whether to preserve the right gastroepiploic vein (RGEV) still remain controversial. This study investigates the safety, feasibility, short- and long-term outcomes of preserving RGEV during laparoscopic right hemicolectomy.Methods:A retrospective cohort study was carried out. Clinical data of 92 patients undergoing laparoscopic right hemicolectomy in Taizhou People's Hospital from March 2016 to May 2018 were retrospectively analyzed. All the patients were treated with complete mesocolon resection (CME) and had complete postoperative pathological data and follow-up data. Based on the tumor location, 49 patients preserved RGEV (preservation group) and 43 did not (non-preservation group). Pathological data, postoperative complications, short- and long-term outcomes were compared between the two groups.Results:There were no significant differences in baseline data between the two groups (all P>0.05). No significant differences were found in operation time, intraoperative blood loss, unplanned reoperation, anastomotic leak, number of harvested lymph nodes, number of metastatic lymph node, and time to food intake after surgery between two groups (all P>0.05). Compared with non-preservation group, the preservation group had faster recovery of anal gas passage after operation [(3.1±1.0) days vs. (4.0±1.7) days, t=-2.787, P=0.007], shorter length of hospitalization [(11.5±1.5) days vs. (15.0±7.9) days, t=-2.823, P=0.007], and reduced the hospitalization expenses [(46 000±5000) yuan to (57 000±33 000) yuan, t=-2.076, P=0.044]. No postoperative gastroparesis (PGS) occurred in the preservation group, while 6 cases in the non-preservation group developed gastroparesis during perioperative period ( P<0.05). The median time of follow-up time was 31.8 (5.2-43.7) months. The overall survival time of the preservation group and non-preservation group was (35.4±1.8) months and (37.6±1.7) months, respectively without significant difference ( P=0.336); the disease-free survival was (32.0±2.2) months and (35.5±2.0) months, respectively without significant difference as well ( P=0.201). Conclusions:Dissection of the Henle's truck and preservation of RGEV is safe and feasible during laparoscopic right hemicolectomy, which can significantly reduce the incidence of postoperative gastroparesis, shorten the recovery time of postoperative intestinal function and hospitalization, and decrease the cost of hospitalization. The efficacy of RGEV preservation is similar to non-preservation of RGEV.

To summarize status quo of clinical application of needleless connectors, to compare effects of different types of airtight connectors in transfusion, their influence on catheter-related blood stream infections and their replacement time, and to summarize disinfecting and nursing methods, so as to provide reference for nurses in choosing best disinfecting method to prevent catheter-related blood stream infections (CRBSI), to improve nursing quality, and to reduce the patients' risk of nosocomial infection.

Objective:The operative approach and steps of laparoscopic right hemicolon cancer radical resection have been standardlized and professional consensus has been reached. However, some detailed issues such as the handling of Henle's trunk and whether to preserve the right gastroepiploic vein (RGEV) still remain controversial. This study investigates the safety, feasibility, short- and long-term outcomes of preserving RGEV during laparoscopic right hemicolectomy.Methods:A retrospective cohort study was carried out. Clinical data of 92 patients undergoing laparoscopic right hemicolectomy in Taizhou People's Hospital from March 2016 to May 2018 were retrospectively analyzed. All the patients were treated with complete mesocolon resection (CME) and had complete postoperative pathological data and follow-up data. Based on the tumor location, 49 patients preserved RGEV (preservation group) and 43 did not (non-preservation group). Pathological data, postoperative complications, short- and long-term outcomes were compared between the two groups.Results:There were no significant differences in baseline data between the two groups (all P>0.05). No significant differences were found in operation time, intraoperative blood loss, unplanned reoperation, anastomotic leak, number of harvested lymph nodes, number of metastatic lymph node, and time to food intake after surgery between two groups (all P>0.05). Compared with non-preservation group, the preservation group had faster recovery of anal gas passage after operation [(3.1±1.0) days vs. (4.0±1.7) days, t=-2.787, P=0.007], shorter length of hospitalization [(11.5±1.5) days vs. (15.0±7.9) days, t=-2.823, P=0.007], and reduced the hospitalization expenses [(46 000±5000) yuan to (57 000±33 000) yuan, t=-2.076, P=0.044]. No postoperative gastroparesis (PGS) occurred in the preservation group, while 6 cases in the non-preservation group developed gastroparesis during perioperative period ( P<0.05). The median time of follow-up time was 31.8 (5.2-43.7) months. The overall survival time of the preservation group and non-preservation group was (35.4±1.8) months and (37.6±1.7) months, respectively without significant difference ( P=0.336); the disease-free survival was (32.0±2.2) months and (35.5±2.0) months, respectively without significant difference as well ( P=0.201). Conclusions:Dissection of the Henle's truck and preservation of RGEV is safe and feasible during laparoscopic right hemicolectomy, which can significantly reduce the incidence of postoperative gastroparesis, shorten the recovery time of postoperative intestinal function and hospitalization, and decrease the cost of hospitalization. The efficacy of RGEV preservation is similar to non-preservation of RGEV.

Objective To explore the value of trauma-care check list (TCC) and quick sequential organ failure assessment (qSOFA) on the early diagnosis of severe trauma with sepsis,and analyze the treatment time lines.Methods Totally 120 patients with severe trauma treated in Taizhou People's Hospital from February 2017 to January 2018 were reviewed.Sixty cases adopted TCC and qSOFA trauma care integration process (integration group),and the rest 60 cases adopted systemic inflammatory response syndrome (SIRS) score and emergency surgery multi-section support process (traditional group).According to the 2016 International Sepsis Guide Criteria,the diagnostic sensitivity and specific degrees of the two groups were calculated.The treatment time node,blood loss,complication rate,postoperative survival rate,and the total length of hospital stay of the two groups were analyzed.Results Of the 60 cases in the integration group,32 cases were confirmed severe trauma with sepsis,and 27 cases were confirmed in 41 primary diagnosed patients,with a diagnostic sensitivity of 84.38％ and a specific degree of 50.00％.In the traditional group,30 cases were confirmed severe trauma with sepsis,and 25 cases were confirmed in 38 primary diagnosed patients with a diagnostic sensitivity of 83.33％ and a specific degree of 56.67％.The significant shorter MDT consultation time,primary diagnosis time of sepsis,the duration from injury to surgery time and total hospitalization time were statistically significant different between the two groups (P＜0.05).Patients in the integration group had significantly lower incidence of postoperative complications and 28-day fatality rate,but there was no significant difference between them (P＞0.05).Conclusions TCC and qSOFA score in the treatment of severe trauma can optimize salvage process,significantly shorten the treatment time,and reduce postoperative complications.Moreover,qSOFA score and SIRS score have the same effect on the early diagnosis of sepsis in patients with severe trauma.

Objective:To construct the eukaryotic cell translation initiation factor 4A3(EIF4A3)short hairpin RNA(shRNA)lentiviral vector,and to establish the Neuro-2a-EIF4A3-shRNA stable transfection cell line.Methods:The EIF4A3 gene sequence was retrieved from the National Center for Biotechnology Information(NCBI)database;the PCR identification primers were designed and synthesized,and connected to the lentiviral GV493 vector digested with Eco R I and Age I enzymes to construct the GV493-EIF4A3-shRNA lentiviral plasmid;PCR method was used to screen the positive clones,which were sequenced for the identification;the GV493 empty plasmid and GV493-EIF4A3-shRNA recombinant plasmid were transfected into the HEK293T cells,regarded as GV493 control lentivirus and GV493-EIF4A3-shRNA lentivirus,respectively.After 48 h of transfection,the lentiviruses were collected for packaging and the viral titer was determined.The Neuro-2a cells were divided into blank group,GV493 control group,and GV493-EIF4A3 shRNA group.The Neuro-2a cells in blank group were untreated,and the Neuro-2a cells in GV493 control group and GV493-EIF4A3 shRNA group were infected with the respective lentiviruses at a multiplicity of infection(MOI)of 100.The infected Neuro-2a cells were selected by 10 mg·L-1 puromycin,and the growth status and green fluorescence expression of the Neuro-2a cells in various groups were observed under fluorescence microscope;real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods were used to detect the expression levels of EIF4A3 mRNA and protein in the Neuro-2a cells in various groups.Results:The PCR sequencing results showed that the gene sequence of the GV493-EIF4A3-shRNA recombinant plasmid was consistent with the designed EIF4A3-shRNA sequence,indicating successful construction of the GV493-EIF4A3 lentiviral vector.The fluorescence microscope observation results showed that there was strong fluorescence expression and good growth status in the HEK293T cells,confirming successful lentiviral packaging.The viral titers for GV493 control lentivirus and GV493-EIF4A3-shRNA lentivirus both were 2×108 TU·mL-1.The growth status of the Neuro-2a cells in GV493 control group and GV493-EIF4A3 shRNA group was good,and they expressed green fluorescence,indicating successful construction of the stable transfection cell line.The RT-qPCR results showed that compared with blank group and GV493 control group,the expression level of EIF4A3 mRNA in the cells in GV493-EIF4A3 shRNA group was significantly decreased(P<0.01).The Western blotting results showed that the specific bands was at a relative molecular mass of 49 000,indicating successful EIF4A3 protein expression in the Neuro-2a cells.Compared with blank group and GV493 control group,the expression level of EIF4A3 protein in the cells in GV493-EIF4A3 shRNA group was significantly decreased(P<0.01).Conclusion:The GV493-EIF4A3-shRNA lentiviral vector is succfssfully constructed,and the Neuro-2a-EIF4A3-shRNA stable transfection cell line is established;the results provide the reference for the study of the effect of EIF4A3 on the intracranial atherosclerosis.

Objective:To construct an over-expression lentiviral vector of the dedicator of cytokinesis 4(DOCK4),and to establish DOCK4 stably over-expressing Neuro-2a cells.Methods:The DOCK4 sequence was searched in the National Center for Biotechnology Information(NCBI)and primers were designed and synthesized;polymerase chain reaction(PCR)method was used to amplify the DOCK4 gene sequences.After digestion with BamH Ⅰ and Age Ⅰ restriction endonucleases,the DOCK4 gene sequences were ligated with the digested lentiviral vector GV492 to construct the GV492-DOCK4 over-expression recombinant plasmid.The positive clones with a similar length to the target gene fragment were screened and identified by PCR method.The GV492-control plasmid and GV492-DOCK4 over-expression recombinant plasmid were transfected into the HEK293T cells,and the lentivirus was collected and titered 48 h after transfection.The Neuro-2a cells were divided into GV492-control group and GV492-DOCK4 group,and the cells were infected with GV492-control lentivirus and GV492-DOCK4 over-expression lentivirus,respectively,and the multiplicity of infection(MOI)was 100.After 72 h of infection,the successfully infected Neuro-2a cells were screened by using puromycin(10 mg·L-1).The growth status of Neuro-2a cells and the expression of green fluorescent protein in various groups were observed under fluorescence microscope.Real-time quantitative PCR(RT-qPCR)and Western blotting methods were used to detect the expression levels of DOCK4 mRNA and DOCK4 protein in the Neuro-2a cells in various groups.Results:The PCR results showed that the gene fragment length of the GV492-DOCK4 over-expression recombinant plasmid was approximately 691 bp.The sequencing results showed that the gene sequence of the GV492-DOCK4 over-expression recombinant plasmid was consistent with the designed over-expression sequence of DOCK4.The titers of the lentiviruses in GV492-control group and GV492-DOCK4 over-expression group were 2.5×108 TU·mL-1 and 2.5×108 TU·mL-1,respectively.The fluorescence microscope observation results showed that Neuro-2a cells in various groups grew well and expressed green fluorescent protein.The RT-qPCR results showed that compared with GV492-control group,the expression level of DOCK4 mRNA in the Neuro-2a cells in GV492-DOCK4 group was significantly increased(P＜0.01).The Western blotting results showed the specific bands near the relative molecular mass of 225 000 in various groups.Compared with GV492-control group,the expression level of DOCK4 protein in the Neuro-2a cells in GV492-DOCK4 group was significantly increased(P＜0.01).Conclusion:This study successfully constructs the DOCK4 over-expression lentiviral vector and establishes the Neuro-2a cells stably over-expressing DOCK4.

Background Per- and polyfluoroalkyl substances (PFASs) are a class of persistent organic pollutants that pose potential health risks to humans. Infants and young children have higher requirements for food safety due to the underdeveloped detoxification and immune systems. Therefore, developing a comprehensive method for determination of PFASs and their novel alternatives in infant complementary food is of great significance. Objective To develop an analytical method using liquid chromatography high-resolution mass spectrometry technology for determination of 55 PFASs in plant- and animal-derived infant complementary fruit purees. Methods Oasis WAX (200 mg, 6 CC) solid-phase extraction columns were used for sample enrichment and purification. The pH of the acetonitrile extract was adjusted using 0%, 1%, 1.5%, and 2% formic acid aqueous solutions to evaluate its impact on the recovery rate of target compounds. Additionally, the impact of a 2 mL methanol wash during the purification process on the recovery of target compounds was assessed to determine the optimal pretreatment conditions. Three types of chromatographic columns—Agilent Poroshell 120 EC-C₁₈, Thermo InfinityLab Poroshell 120 Aq-C₁₈, Acquity Waters BEH-C₁₈, and changes in mobile phase, were compared for their effects on retention time, peak shape, and response of target compounds. The method was validated in terms of selectivity, linear range, detection limit, and precision. The established method was applied to 49 commercial samples of infant complementary fruit purees. Results Adjusting the sample pH using 1.5% formic acid water and incorporating a 2 mL methanol wash during purification achieved satisfactory recovery rates. The target compounds were chromatographically separated using an Agilent Poroshell 120 EC-C₁₈ column with a gradient elution system. The mobile phase consisted of methanol-water (methanol/water: 2/98, v/v) containing 5 mmol·L⁻¹ ammonium formate as mobile phase A, and methanol as mobile phase B. Good separation was achieved within 15 min, resulting in optimal chromatographic peak shapes. The 55 target compounds exhibited good linearity across the standard curve range, with correlation coefficients (R²) greater than 0.99. The method detection limits ranged from 0.02 to 0.05 µg·L⁻¹. In the plant- and animal-based fruit puree samples, the spiked recovery rates ranged from 60% to 112% and 57% to 119%, respectively, with relative standard deviations (RSD) ≤ 30%. A total of 9 traditional PFASs and 5 novel PFASs were positive in 49 samples of infant complementary fruit purees. Conclusion This method enables comprehensive detection of 55 traditional and emerging PFASs, offering wide coverage, high accuracy, and excellent sensitivity. It provides technical support for characterizing contamination by traditional and emerging PFASs in food matrices.