Objective To improve the comprehensive nursing abilities in the practice process in the practice base, to adapt to the needs of the development of community nursing. Methods Convenient sampling was adopted, 83 nurses were divided into the experimental group (43 nurses) and the control group (40 nurses),who interned in the practice base in the years 2008 and 2009, the control group received con-ventional teachings, and the experimental group was given the teaching method and modes which were targeted at and focusing on the training of ability. The practice result was compared between the two groups.- Results Based on the teachers, the assessment and mixed capability were higher in the experimental group, by the employers' evaluation, all of the indicators were higher than the control group, and it is statistically significant. Conclusions It can improve various nursing abilities of the community nurses by the teaching method and modes which are targeted and focusing on the training of capability.

Objective To use peer education to guide community diabetic patients to adopt diet therapy using food exchange method in order to explore effective method for diet therapy of diabetes mellitus. Meth-ods 91 diabetic patients were selected using simple sampling method and randomly divided into the peer ed-ucation(45 cases) and the common education group(46 cases), the two groups adopted food exchange method for diet therapy for 1 year. The blood glucose, blood lipid, glycosylated hemoglobin and body weight index were compared between the two groups using t test. Results The blood glucose, blood lipid, glycosylated hemoglobin and body weight index all decreased in the two groups after intervention, but the the decreased de-gree in the peer education group was more obvious. The fasting blood glucose, 2 hour postprandial blood glu-cose, glycosylated hemoglobin, triglyceride, low-donordensity lipid protein and body weight index in the peer education were lower thanthose of the common education group, but HDL-C was higher. Conclusions Peer education is more effective in health education of food exchange method.

Objective To compare the effect of endoscopic ultrasonography (EUS),magnetic resonance chlangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) in the diagnosis of suspicious intermediate choledocholithiasis.Methods One hundred and eighty-six patients with suspicious intermediate of choledocholithiasis successively received MRCP,EUS,and ERCP examination.The stone taking out by endoscopic as diagnositic standard,and the sensitivity,specificity and accuracy in different methods was compared.Results Sensitivity and accuracy of EUS was significantly higher than that of MRCP [97.5％(155/159) vs.92.5％(147/159),97.3％(181/186) vs.91.9％(171/186)](x2 =4.21,5.30,P =0.04,0.02).There was no statistically significant difference between EUS and ERCP in specificity [96.3％(26/27) vs.88.9％ (24/27)] (x2 =115.40,P ＜ 0.05).Sensitivity,specificity and accuracy of ERCP was 98.9％(184/186),98.7％(157/159) and 100.0％(27/27),and there was no difference between EUS and ERCP in the diagnosis of choledocholithiasis (P ＞ 0.05).Conclusions EUS is similar with ERCP for the diagnosis of choledocholithiasis.By performing EUS or MRCP first,ERCP may be avoided in patients with suspicious intermediate choledocholithiasis.

Objective To investigate the effects of acyl-CoA synthetase 5 (ACS5) silencing by siRNA on expression and proliferation of colon carcinoma cell lines.Methods The expression of ACS5 in 30 case colon carcinoma and adjacent tissues were analyzed by immunohistochemical staining.The siRNA of ACS5 with Lipofectamine2000TM was transfected into colon carcinoma cell lines (HT-29 and SW480).The expression of ACS5 in colon carcinoma cell lines (HT-29 and SW480) was detected by real-time reverse transcription polymerase chain reaction.Proliferation of colon carcinoma cell lines was analyzed by 3-(4,5-dimenthylthiazol-2-yl)-5-(3-carboxymethoxy-phenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS).Results The expression of ACS5 in colon cancer was significantly higher than in adjacent tissues by immunohistochemical staining.The mRNA of ACS5 in siRNA-ACS5 group (0.18 ± 0.03) was significantly lower than in NC siRNA group (2.55 ± 0.31) and blank control group (2.48 ± 0.12) in HT-29 colon cancer lines,and the inhibition ratio was 92.96％ (F =146.9,P ＜0.01).The mRNA of ACS5 in siRNA-ACS5 group (0.14 ± 0.01) was significantly lower than in NC siRNA group (1.21 ± 0.05) and blank control group (1 ± 0.03) in SW480 colon cancer lines,and the inhibition ratio was 88.5％ (F =826.5.9,P ＜ 0.01).Proliferation of HT-29 and SW480 colon cancer line in siRNA-ACS5 group was slower on 72 h and 96 h than in NC siRNA group and blank control group (P ＜ 0.05).Conclusions Expression of ACS5 is elevated in colon cancer tissues.siRNA interference of colon cancer line downregulated ACS5 expression and inhibited the proliferation of the colon cancer cells.

Objective To explore the relationship between dyslipidemia and colorectal cancer.Methods The levels of total cholesterol(TC),triglyceride (TG),1ow density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) of 182 patients with colorectal cancer and 86 controls were tested.The serum lipids levels between the colorectal cancer group and control group,colorectal cancer with different location,different gender were compared.Results The level of TC in the colorectal cancer group [(5.51 ± 0.76) mmol/L] was significantly higher than that of the control group [(4.84 ± 0 53) mmol/L] (t =2.41,P ＜ 0.05) ; The level of HDL-C in the colorectal cancer group[(0.85 ± 0.26) mmol/L] was significantly lower than that of the control group [(1.24 ± 0.27) mmol/L] (t =-3.56,P ＜ 0.05).There were no significant differences in the 1 evels of TG and LDL-C between the colorectal cancer group and control group(t＝0.89,1.45,all P ＞ 0.05).TC level in the male colorectal cancer group [(5.96 ± 0.87) mmol/L] was significantly higher than that of the female colorectal cancer group [(5.26 ± 0.74) mmol/L] (t =2.10,P ＜ 0.05).The level of TC in the distal colon and rectal cancer group was (6.07 ± 0.78) mmol/L,which was significantly higher than (5.14 ± 0.56)mmol/L of the proximal colon cancer group (t =3.24,P ＜ 0.05) ;The level of HDL-C in the distal colon and rectal cancer group was (0.75 ± 0.26) mmol/L,which was significantly lower than (1.07 ± 0.19) mmol/L of the proximal colon cancer group (t =-3.20,P ＜ 0.05).Conclusion TC was positively correlated with colorectal cancer,and HDL-C was negatively correlated with colorectal cancer.

Objective To establish the background information of physiological parameters for germ?free ( GF ) Taihu piglets. Methods In this study we selected 25 days old GF Taihu piglets and 4 conventional ( CV) littermates, the male and female ratio was 1∶3, to measure the normal clinical values of hematology and serum biochemistry, immunoglobu?lin concentration and main organ coefficients. The analysis of relative growths of main organ weight to body weight was con?ducted in the Taihu GF and CV pigs by allometric scaling model. Results (1) Twelve hematological parameters and 8 blood biochemical parameters in the GF piglets were significantly lower than those in CV pigs (P<0?05). (2) The aver?age body weight, IgM concentration of GF pigs and CV pigs had significant difference ( P <0?05 ) , and no mesenteric lymph nodes were found in the GF pigs. (3) The gut weight had the largest allometric association with body weight in the GF pigs, while spleen weight has the largest allometric association with body weight in the CV pigs. Both the weight of heart and stomach in CV and GF pigs had a negative allometric association with body weight (allometric coefficient b<1), respectively. Conclusions Different microbe control grades affect the body weight, hematology and serum biochemistry, expression of immunoglobulin and development of main organs in laboratory pigs.

ObjectiveTo investigate the risk factors for long-term complications after endoscopic sphincterotomy (EST) for benign biliary and pancreatic diseases. MethodsThe follow-up data of the patients who underwent EST in Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, from July 2008 to June 2013 were analyzed retrospectively, and the risk factors for long-term complications after EST were investigated. The chi-square test was applied for comparision of categorical data betwee groups. The Kaplan-Meier method was applied to analyze the cumulative incidence of complications, and the univariate and multivariate logistic regression analyses were applied to investigate the risk factors for long-term complications. ResultsThe patients were followed up for 4-57 months, and the mean follow-up time was 30.9±12.1 months. The cumulative incidence of long-term complications after EST was 9.9% (18/182), and these complications included recurrent common bile duct stones (n=9), recurrent cholangitis (n=6), acute cholecystitis (n=2), and biliary stricture (n=1). There were significant differences between the two groups in diameter of common biledute, pneumobilia, and juxtapapillary diverticulum(all P＜005). The multivariate logistic regression analysis showed that diameter of common bile duct ≥15 mm (OR=4.82, 95%CI: 1.08-21.55, P=0.040) and pneumobilia (OR=6.19, 95%CI: 1.23-31.23, P=0.027) were the risk factors for long-term complications after EST. ConclusionThe incidence of long-term complications after EST for benign biliary and pancreatic diseases is low, and diameter of common bile duct ≥15 mm and pneumobilia are the risk factors for long-term complications after EST.

Objective:To explore the psychological recovery pathway and support needs of second victims of nurses who have experienced medical adverse events through qualitative research.Methods:From June to December 2022, a purposive sampling method was used to select 20 nurses who had experienced level Ⅲ or above adverse events and voluntarily participated in this study from 3 grade A tertiary hospitals in Hubei Province and 1 grade A tertiary hospital in Sichuan Province. Semi-structured interviews were conducted with the research subjects and the data was analyze by using thematic analysis.Results:The psychological recovery path of nurses who had experienced medical adverse events included three stages, named as the plateau period, stress response period, and coping and growth period. The second victim of nurses hoped to receive support from the department′s environmental culture, organizational atmosphere, and non punitive culture, and nurses in the platform stage had a stronger need for the first two types of support; the nurses preferred emotional support from superiors, colleagues, family/friends during the stress response period, and preferred knowledge learning and training support during the coping and growth period.Conclusions:The psychological recovery of the second victim of nurses will go through a plateau period, a stress response period, and a coping and growth period. There are differences in support needs during each period, and more targeted intervention plans should be developed.

Objective To explore the clinical effect of endoscopic sclerosing agent and tissue glue injection combined with ligation in the treatment of rectal ectopic varices(EV)bleeding.Method A retrospective analysis was conducted on 60 patients with rectal EV bleeding who received endoscopic treatment from January 2017 to January 2022.According to the surgical method,the patients were divided into two groups,with 30 cases in the control group receiving endoscopic ligation treatment;30 cases in the observation group were treated with endoscopic scleroing agent and tissue glue injection combined with ligation.Follow up was conducted according to a cycle of 1,3,6 and 12 months after surgery,and the following indicators were compared between the two groups of patients:successful surgical hemostasis rate,incidence of postoperative complications,mortality rate,improvement of postoperative varicose vein diameter,and postoperative response rate.Result The success rate of surgical hemostasis in the observation group was 93.3%,significantly higher than 66.7%in the control group,the incidence of abdominal pain and fever in the observation group was 10.0%and 10.0%,respectively,significantly lower than 33.3%and 36.7%in the control group,there were 2 deaths in the observation group and 9 deaths in the control group,the mortality rate in the observation group was 6.7%,significantly lower than the 30.0%in the control group,the preoperative venous diameter of the observation group was(1.60±0.36)cm,and the postoperative diameter continued to decrease,at the 12th month after surgery,the diameter was(0.78±0.31)cm,while in the control group,the preoperative venous diameter was(1.52±0.26)cm,the postoperative diameter continued to increase,and at the 12th month after surgery,the diameter was(1.55±0.36)cm,the postoperative effective rate of the observation group was significantly better than that of the control group,the differences were statistically significant(P<0.05).Conclusion The combination of endoscopic scleroing agent and tissue glue injection combined with ligation for the treatment of rectal EV bleeding has a higher success rate and effective rate of surgical hemostasis,fewer postoperative complications,lower mortality rate during follow-up observation,and satisfactory clinical efficacy.It is worth further promoting and applying in clinical practice.