Objective To study on the effectiveness and reliability of endoscopic varicose vein ligation (EVL) combined with hand-assisted laparoscopic splenectomy (HLS) in portal hypertensive patients. Methods Retrospectively 15 cases of EVL combined with HLS were reviewed from June 2001 to October 2004. These patients with severe esophageal varicose and hypersplenism were adapted to perform endoscopic varicose vein ligation, then 1 -2 weeks after the varicose became milder or disappeared, hand-assisted laparoscopic splenectomy was conducted. Results The number of preoperative ligation was 2. 2 times in average. Esophageal varicose was completely disappeared in 11 and mild in 4. There were no postoperative complications, conversion and death in Hand-assisted laparoscopic splenectomy. The average postoperative count of platelets were (38-67) ? 106/L preoperatively raised to (89-310) ? 106/L postoperatively. In the follow up period (average 17. 6 months) , no varicose vein bleeding happened. Conclusions EVL combined with HLS is not only minimal invasive, but also a secure and effective measure for portal hypertension.

OBJECTIVETo examine the growth-inhibitory, apoptosis- and necrosis-inducing effects of realgar nano-particles (RNP) in human chronic myelogenous leukemia cell line K562 and acute myeloid leukemia cell line HL-60, and to find out the chemical species with efficacy.

METHODA "solvent-relay" strategy was used for the preparation of RNP suspension. Cell viability was determined by MTT assay. Cell apoptosis and necrosis were characterized with Annexin V-PI double staining in association with flow cytometry and with morphological examination with Hoechst 33258 staining. Parallel experiments with arsenous acid (H3AsO3), the dominant form of arsenic trioxide in the solution, were conducted for comparison.

RESULTThe mean diameter of RNP was 159.0 nm. RNP showed growth-inhibitory effect on both cell lines. The double staining test indicated that RNP induced both apoptosis and necrosis, and this was further confirmed by morphological examination.

CONCLUSIONRNP induced both apoptosis and necrosis in leukemia cell lines K562 and HL-60. Thioarsenite species with both As-O and As-S bonds may be the active intermediates in the RNP.

Antineoplastic Agents ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; administration & dosage ; pharmacology ; Cell Proliferation ; drug effects ; HL-60 Cells ; pathology ; Humans ; K562 Cells ; pathology ; Materia Medica ; administration & dosage ; pharmacology ; Nanotechnology ; Necrosis ; Particle Size ; Sulfides ; administration & dosage ; pharmacology

Objective:To study the risk factors of acute gallstone pancreatitis (AGP) caused by impaction of duodenal papilla stones based on ERCP findings to provide evidence on prevention of AGP caused by stone impaction.Methods:The data of 304 patients with duodenal papilla stone impaction who were treated by ERCP at the Integrated Chinese and Western Medicine Hospital of Tianjin University from January 2009 to December 2020 were analyzed retrospectively. There were 177 males and 127 females, with a median age of 65.0 years. These patients were divided into the AGP group ( n=174) and the non-AGP group ( n=130) according to whether they developed acute pancreatitis before hospitalization. The analysis was performed on perioperative data. Multivariate logistic regression analysis was used to detect risk factors of AGP in patients with duodenal papillary stone impaction. Results:Multivariate logistic analysis showed that acute cholangitis ( OR=2.114, 95% CI: 1.279-3.494, P<0.05) and impacted stones ≤5 mm ( OR=1.738, 95% CI: 1.064-2.840, P<0.05) were independent risk factors of duodenal papillary stone impaction complicated with AGP. No perforation and death related to ERCP treatment occurred in both groups. The symptom alleviating time of patients in the AGP versus the non-AGP groups was (2.67±1.19) versus (1.88±0.88) d respectively ( t=-6.321, P<0.001). Conclusion:Among patients with duodenal papilla impacted stones, acute cholangitis and impacted stones ≤5 mm were risk factors of developing AGP, and ERCP should be carried out as early as possible.

Objective:To investigate the effects of macrophage migration inhibitory factor (MIF) on AMPK/ERK/mTOR autophagy signaling pathway in primary human umbilical vein endothelial cells (HUVEC) after dengue virus type 2 (DENV2) infection.Methods:The virulence of DENV2 to C6/36 cells was assessed with 50% tissue culture infectious dose (TCID 50). NS1 gene fragments in DENV2-infected HUVEC were detected by RT-PCR. Transmission electron microscopy was used to detect autophagosomes. Western blot was performed to detect the effects of DENV2 infection on the expression of autophagy-related protein LC3-Ⅱ and MIF in HUVEC. The correction of MIF with LC3-Ⅱ was then analyzed. HUVEC were pretreated with MIF inhibitor (ISO-1) or pathway inhibitor (Compound C or U0126), and then the changes in the expression of MIF, adenosine 5′-monophosphate-activated protein kinase (AMPK) pathway-related proteins and LC3-Ⅱ after DENV2 infection were detected by Western blot to reveal the correlation between MIF and AMPK autophagy pathway. Results:The TCID 50 to C6/36 cells was 10 -9.09/ml in this experiment. NS1 gene fragments were detected in DENV2-infected HUVEC. Autophagosomes or autophagolysosomes were observed in the infected HUVEC and there were differences in autophagy induced by different doses of DENV2. The mRNA levels of MIF and LC3-Ⅱ in HUVEC were positively correlated after DENV2 infection. MIF inhibitor affected AMPK, ERK and LC3-Ⅱ levels, but had no significant influence on MIF expression at protein level. Conclusions:MIF could affect autophagy through regulating the AMPK/ERK/mTOR signaling pathway in HUVEC during DENV2 infection.

Objective To systematically evaluate the effect of sequence of pulmonary artery and vein transection in thoracoscopic lobectomy on the efficacy and safety of patients with non-small cell lung cancer. Methods PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM databases were searched for the researches on The post-operative efficacy of pulmonary arteriovenous and pulmonary vein resection sequence in thoracoscopic lobectomy for non-small cell lung cancer. The retrieval time is from the database construction to May 2022. Meta-analysis was performed using RevMan 5.4 software. Results Eight articles were included, including 3 randomized controlled studies and 5 cohort studies, with a total of 1810 patients. Meta-analysis results showed that: The operative time (MD=13.34, 95%CI(7.36, 19.32), P < 0.0001) and intraoperative blood loss (MD=45.29, 95%CI(40.24, 50.35), P < 0.0001) in the group with priority pulmonary vein resection were significantly higher than those in the group with priority pulmonary vein resection. The difference was statistically significant. However, the benefits of OS (HR=1.34, 95%CI (1.12, 1.60), P=0.001) and DFS (HR=1.44, 95%CI(1.18, 1.76), P=0.0003) in the group of priority pulmonary vein transection were significantly better than those in the group of priority pulmonary artery transection, with statistically significant differences. Conclusion Priority pulmonary vein transection during thoracoscopic lobectomy effectively improved patients' OS and DFS, resulting in higher survival benefit for patients with non-small cell lung cancer, but intraoperative bleeding and operation time are more than those with priority pulmonary artery transection.

Objective To investigate the effect evaluation of nurse manager′s nursing round system on improving ward nursing management level. Methods The self-designed nurse manager′s nursing round observe evaluation form and effect evaluation questionnaire were used to comprehensively evaluate implementation and effects of nurse manager′ s nursing round system. Results The nurse manager′ s nursing round observe evaluation form score was (95. 05 ± 2. 75), the scores of nurse manager′s nursing round system evaluated by patients, nurses and nurse manager were (33. 70 ± 2. 65),(49. 73 ± 0. 98) and (33. 05 ± 3. 86). Multivariate analysis showed that, increase nurses′ attention, increase a sense of security and belonging, enhance the ability of nurses to report illness and critical thinking ability, improve overall care quality can improve evaluation for the system(P < 0. 05). Conclusions The establishment and implementation of nurse manager′s nursing rounds system has improved the wards nursing management level, and patients, nurses and nurse managers give high evaluations for the system.

OBJECTIVETo analyze the epidemiological features of the index cases of severe acute respiratory syndrome (SARS) occurred in different cities in Guangdong province and to trace for the source of infection.

METHODSStandardized individual case inventory was adopted to conduct investigation on index cases and on persons who had close contact with index cases in Guangdong province. Data on the epidemiological characteristics, secondary cases and the links among index cases were analyzed.

RESULTSBetween November 16, 2002 and April 16, 2003, there had been 13 index cases of SARS including 3 cadres, 3 farmers, 2 retirees, 2 workers and 1 shop attendant, reported from 13 cities in Guangdong province. Between November 2002 and January 2003, there had been 7 cities reported to have identified index cases of SARS with 6 of them being infected in their own cities and 1 imported from Guangzhou city. All of the cases had no close contacts to similar patients but 6 of them later caused 2nd or even 3rd generation cases of SARS. Most cases hit young people (7/13) with a sex ratio of 1:0.6. The fatality rate of index cases was high (4/13).

CONCLUSIONNo evidence showed that there was direct transmission among the index cases. Data regarding the geographical origin of those index cases led to the assumption that the infection had started in six cities of Pearl river delta region and the Hong Kong Special Administrative Region.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Contact Tracing ; Female ; Hong Kong ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Severe Acute Respiratory Syndrome ; epidemiology ; transmission

Objective:To evaluate the clinical efficacy and prognosis of robotic-assisted thoracoscopic surgery (RATS )compared with traditional thoracoscopic surgery (VATS) in the treatment of thymoma.Methods:The clinical data of 128 patients with thymoma who underwent surgery in our hospital from January 2006 to November 2019 were retrospectively analyzed, There were 83 males and 45 females. The age ranged from 23 to 76 years old, with an average of (45.89±13.84) years old. The patients were divided into RATS group (58 cases) and VATS group (70 cases). Cox proportional risk model was used to analyze the factors affecting the postoperative hospital stay. Results:Compared with VATS group, RATS group patients had longer operation time[(128.61±32.13)min vs. (96.42±45.37)min, P=0.036], less intraoperative blood loss[(35.25±5.62)ml vs. (58.36±3.65)ml, P=0.016], less blood transfusion (1.72% vs. 7.14%, P=0.029), and less postoperative complications (17.2% vs. 22.9%, P=0.039). The average total hospitalization cost was higher [(56 721.18±98 457.24) yuan vs. (25 135.68±12 403.29) yuan, P<0.001], and the average postoperative hospitalization time was shorter[(4.15±1.51) days vs. (6.65±2.74)days, P<0.001], all with statistically significant differences. However, there was no statistical differences in conversion to thoracotomy, intraoperative complication, the surgical margin was positive, postoperative infectionpostoperative drainage amount, postoperative drainage time, expenses for medicine and anesthetic fee( P>0.05). Multiple linear regression models showed that different groups ( P=0.013), age ( P=0.025), combined with myasthenia gr avis( P=0.047), combined with underlying disease( P=0.016), intraoperative blood loss( P=0.034), conversion to thoracotomy ( P=0.024), postoperative infection( P=0.008), postoperative complications( P=0.026) and postoperative drainage time ( P=0.031) affected postoperative hospital stay. Conclusion:Robot-assisted thymectomy is a safe and effective method for the treatment of thymomas. RATS recover faster after surgery with fewer complications and shorter hospital stays than RATS after thoracoscopic surgery, but more large, high-quality studies are needed to evaluate the effectiveness of RATS.

Objective    To explore the application of Toumai® minimally invasive endoscopic robot in thoracic surgery, and to observe its safety and short-term surgical efficacy. Methods    Three patients were enrolled from October to December 2021, including 1 male (69 years) and 2 females (47 years and 22 years). All 3 patients received surgery with Toumai® endoscopic surgical robot, including radical lung cancer surgery in 2 patients and mediastinal tumor resection in 1 patient. Results    All 3 patients were successfully operated without conversion to thoracotomy, complication or death. For the male lobectomy patient, the total operation time was 120 min, the intraoperative blood loss was 100 mL, the catheter drainage time was 4 days and the hospital stay time was 5 days. For the female lobectomy patient, the total operation time was 103 min, the intraoperative blood loss was 100 mL, the catheter drainage time was 4 days and the hospital stay time was 5 days. For the female mediastinal tumor patient, the total operation time was 81 min, the intraoperative blood loss was 50 mL, the catheter drainage time was 3 days and the hospital stay time was 3 days. Conclusion    The Toumai® minimally invasive endoscopic surgical robot is safe and effective in thoracic surgery. Compared with Da Vinci surgical robot, Toumai® has the same 3D visual field experience and smooth operation.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.