Objective To investigate the influence of remote care management on the diet compliance and disease recurrence of patients with pancreatitis. Methods Seventy-four simple pancreatitis patients in our hospital from January 2013 to March 2014 were involved and numbered according to the administration order and divided into the observation group and the control group according to the random number table with 37 cases in each group. The two groups accepted conventional health education during hospitalization time. The control group was given intensive classes after discharge, while the observation group received remote care management. Twelve months later, the rate of disease recurrence and diet compliance of the two groups were observed and compared. Results After the management, the observation group was superior to the control group in diet compliance. The rate of disease recurrence was significantly lower in the observation group than that of the control group (all P<0.05). Conclusion The remote care management can effectively improve the diet compliance of pancreatic patients, lower the recurrence rate, and have positive effect on prognosis.

Objective To explore the accuracy and practical significance of the 3-dimensional (3D) reconstruction of the liver and the abdominal blood vessels based on the data of 64-slice spiral computerized tomography (64S-SCT). Methods The 2D images of the liver and the abdominal blood vessels were collected after TLC-scanning with 64S-SCT. The 3D images of the liver, hepatic internal duct system and the abdominal blood vessels were reconstructed by the medical image processing system. The volume of the 3D reconstructed liver was compared with that of the actual liver measured by the 64S-SCT, and the portal vein of the reconstructed liver model was compared with that reconstructed by the Mxview workstation based on the 64S-SCT data. Results The 3D models of the liver, hepatic internal duct system and abdominal blood vessels were vivid, and could be revolved and observed at any direction. The spatial relationship among main intrahepatic ducts was clearly displayed. The actual liver volume and the condition of the intrahepatic ducts were accurately demonstrated. The reconstructed liver, the branches of the hepatic artery and portal vein, and the abdominal blood vessels were simultaneously displayed by adjusting the transparency of the liver model. The portal vein of the reconstructed liver model completely matched that reconstructed by the Mxview workstation based on the 64S-SCT data. Conclusions The 3D models of the liver, hepatic internal duct system and abdominal blood vessels reflect the human anatomy structure, and provide reliable virtual organs and vessel system for virtual liver surgery.

Objective To evaluate the effect of bundles of care on the prevention of postoperative delirium among elderly patients with hip fractures.Methods A prospective randomized case control study was conducted on 80 patients (≥65 years old) with hip fractures from March 2017 to June 2017.The patients were divided into experimental group (n =43) and control group (n =37) according to the random number table method.The experimental group received bundles of care,while the control group received routine nursing.The patients in both groups were all surgically treated,and the confusion assessment method (CAM) was applied to diagnose delirium after surgery.Gender,age,fracture type,duration from injury to operation,internal fixation type,operation time,total amount of bleeding,visual analogue scale (VAS),incidence of delirium,complications,and adverse events were compared between the two groups.Results Among the 80 patients,there were 11 males and 69 females,aged averagely 79.3 years (range,65-95 years).No significant differences were found between experiment group and control group in terms of gender (male:6 cases vs.5 cases,females:37 cases vs.32 cases),age [(79.8 ± 7.8) years vs.(78.7 ± 8.9) years],cause of injury (traffic injuries:7 cases vs.4 cases;falling injuries:36 cases vs.33 cases),duration from injury to operation [(66.1 ±14.3)hours vs.(63.4 ±14.9) hours],fracture type (femoral neck:13 cases vs.10 cases;intertrochanteric:26 cases vs.24 cases;subtrochanteric:4 cases vs.3 cases),internal fixation type (artificial total hip:5 cases vs.5 cases;artificial femoral head:8 cases vs.5 cases;PFNA:29 cases vs.27 cases),operation time [(55.5 ± 16.8) minutes vs.(51.6 ± 17.0) minutes],total blood loss [(114.4 ± 73.9) ml vs.(108.1 ±72.0) ml] (P ＞ 0.05).After bundles of care intervention,the postoperative VAS [(2.2 ± 0.8) points vs.(4.3 ± 1.2) points],postoperative delirium incidence (9％ vs.32％),incidence of complications and adverse events (2％ vs.19％) in experimental group were significantly lower than those in control group (P ＜ 0.05).Conclusion Bundles of care can relieve the pain and effectively reduce the incidences of postoperative delirium,complications,and adverse events in elderly patients with hip fracture.

Objective:To analyze the health literacy level among medical staff and its influencing factors.Methods:Using the convenient sampling method, the in-service medical staff from four medical institutions (Shanghai Pudong New Area People′s Hospital, Shanghai Pudong New Area Zhoupu Hospital, Shanghai Tenth People′s Hospital Chongming Branch, and Shanghai Jing′an District Zhabei Central Hospital) were administered with a national residents′ health literacy questionnaire uniformly compiled by the China Health Education Center, and an electronic questionnaire independently compiled in combination with professional characteristics of the medical staff. The survey period was January 5-17, 2021. The contents of the questionnaire included basic information regarding gender, age, education, and professional title. Respondents were also asked whether they had chronic diseases, and three aspects of health literacy for basic knowledge and concepts, healthy lifestyle and behavior and health skills covering six other types of health problems including scientific outlook on health, infectious disease prevention and control literacy, chronic disease prevention and control. Safety and first aid literacy, basic medical literacy, health information literacy were also assessed. The total score for the questionnaire was 100 points. Respondents with a score of 80 or more were considered to have a competent health literacy. A total of 870 questionnaires were distributed, excluding incomplete ones, 826 valid questionnaires were used for analysis. Logistic regression was used to analyze factors influencing the health literacy among medical staff.Results:The overall health literacy level of medical staff was 64.0%, with 79.7% of respondents indicating that they had basic knowledge and concepts, 70.8% indicating that they practiced healthy lifestyles and behaviors, and 33.5% showed proficiencies in terms of health skills. From high to low, the health literacy levels for the six types of health problems were safety and first aid literacy (80.5%), scientific outlook on health (76.4%), infectious disease prevention and control literacy (60.2%), chronic disease prevention and control literacy (70.9%), basic medical literacy (52.7%), and health information literacy (50.2%). The results of a multivariate logistic regression analysis showed that physical condition, a lifestyle harmful to one′s health, highest educational background, and a professional title in the previous year were the independent influencing factors related to health literacy ( P<0.05). Conclusion:Levels of health skills, basic medical literacy, and health information literacy among medical staff are low, and physical condition in the previous year, lifestyle, professional title, and education are important factors influencing the level of health literacy among medical staff.

Objective To evaluate the effects of preoperative regional intra-arterial infusion chemotherapy for patients with advanced gastric cancer (AGC). Methods A total of 82 patients with clinical stage Ⅲ,Ⅳ gastric cancer received two cycles of neoadjuvant regional intra-arterial infusion chemotherapy (arterial infusion group, n=42) or neoadjuvant systemic chemotherapy (systemic chemotherapy group, n=40). The operation was administrated in 10 to 15 days before chemotherapy. All patients received 6 course of systemic chemotherapy after surgery. Chemotherapy toxicity and sur-vival rate were retrospectively analyzed. Results No significant difference was found in chemotherapy toxicity between two groups. The median survival period was 25.3 months in arterial infusion group and 19.1 months in systemic chemotherapy group. 3-year survival rate was 36.4% in arterial infusion group and 21.0% in systemic chemotherapy group respectively, there were significant differences (P<0.05). Conclusion Preoperative regional intra-arterial infusion chemotherapy is well tolerated in advanced gastric cancer patients and could improve short-term survival.

Objective:A DNA coordination polymer(Ca-pHis-Apt1 9S)was synthesized and its effect on the activity of bone marrow stem cells(BMSCs)was investigated. Methods:BMSCs were extracted from the epiphysis of the femoral shaft of mice by adherence screening method and identified by the expression of surface antigens through flow cytometry.Cell penetrating peptide pHis was covalently linked with the BMSCs aptamer Aptl9S,and a DNA coordination polymer(Ca-pHis-Aptl 9S),which was expected to improve the viability of BMSCs,was prepared through coordination assembly with calcium ions.BMSCs were treated with different concentrations of Ca-pHis-Apt1 9S,and the effects of Ca-pHis-Apt1 9S on the biological activities and the phenotype of BMSCs were evaluated by CCK-8 assay,live/dead cell staining assay and flow cytometry assay.The targeting ability of Ca-pHis-Apt1 9S toward BMSCs was observed using a fluorescence confocal microscope.Meanwhile,CCK-8 assay was used to study the main components of Ca-pHis-Aptl 9S that could promote the viability of BMSCs. Results:Spherical Ca-pHis-Apt1 9S with the particle size of 50-120 nm was successfully synthesized.The synthesized Ca-pHis-Apt1 9S could significantly promote the viability of BMSCs(P＜0.05)without affecting the apoptosis or the expression of surface antigens(CD29,CD44 and CD34).Confocal microscopy analysis showed that the BMSCs aptamer Apt19S could further enhance the cellular uptake of Ca-pHis-Apt1 9S by BMSCs.The results of CCK-8 assay revealed that pHis in Ca-pHis-Apt1 9S was the main component that could promote the viability of BMSCs,and this promotional effect was dose-dependent(P＜0.05). Conclusion:Ca-pHis-Aptl 9S can target BMSCs in vitro and significantly promote their biological activity without affecting their phenotype,providing a new method for the in vitro culture of BMSCs.