Objective To improve the understanding of acute typhlitis.Methods all 5 cases of acute typhlitis from February 1999 to August 2001 were reviewed,5 cases were preoperatively misdiagnosed as acute appendicitis and subsequently performed emergency operations.Moreover,misdiagnosis was made intraoperatively as tumor in 2 cases,Crohn disease in 2 cases and diverticulitis in 1 case.Right hemicolectomy was performed in 4 cases;resection of necrotic mass and ileostomy was performed in 1 case.Results The pathologic change was acute non-specific inflammation of cecum in 5 cases.All cases recovered uneventfully.They are in good condition during the follow-up range 4 to 30 months.Conclusions The clinical manifestation of typhlitis was nonspecific.It was extremely difficult to diagnose preoperatively.Inflammatory mass of external lateral wall of cecum was characteristic finding of typhlitis during laparatomy.It is difficult to differentiate from tumor or Crohn disease at intraoperation.Right hemicolectomy was satisfactorily recommended.

Objective To summarize the experience in the diagnosis and treatment of traumatic spleen rupture.MethodsThe diagnosis and treatment of consecutive 293 patients with traumatic spleen rupture from January 1992 to October 2000 were reviewed.ResultsThe diagnosis was established by the history of injury, clinical presentations, diagnostic peritoneal punctures, abdominal ultrasonography and/or CT. The accuracy rate of diagnosis was 96 3% (282/293). Thirty one patients were treated nonoperatively and cured. Two hundred and fifty of 259 patients treated operatively were cured.Seven had postoperative complications with effusion in the splenic fossa.The total cure rate was 95 9%(281/293).Twelve patients died of uncontrolable hemorrhage or severe multiple injuries.ConclusionsSplenectomy for the treatment of traumatic spleen rupture is satisfactory.The morbidity and mortality of splenectomy are low.

Objective To investigate the relationship between continuous hyperglycemia and the progression of early acute pancreatitis (AP) Methods Five hundred and twelve AP patients were included in this study, in which 418 patients were mild acute pancreatitis (MAP) and 94 were severe acute pancretitis (SAP) Fasting blood sugar was determined and APACHE Ⅱ score was calculated on admission, 2nd and 3rd day of hospitalization respectively Serum tumor necrosis factor (TNF?) and C reaction protein (CRP) levels were determined on the 2nd day of hospitalization Results The incidence of hyperglycemia was higher in SAP patients than that in MAP patients (74 5% vs 25 8%, P =0 001) In SAP, APACHE Ⅱ score in continuous hyperglycemia group (CHG) was significantly higher than that of non continuous hyperglycemia group (NCHG) on admission, 2nd and 3rd day of hospitalization respectively (13?4 vs 11?3, P =0 017; 13?4 vs 11?3, P =0 010; 14?4 vs 10?4, P =0 010, respectively) Continuous hyperglycemia was related to the severity of SAP ( ? 2=7 77, P =0 005) Moreover, serum TNF? and CRP levels of the CHG were also markedly higher than that of NCHG (20?14 vs 14?11, P =0 019; 123?81 vs 93?55, P =0 036, respectively) Conclusion Continuous hyperglycemia might be a risk factor for the aggravation of early acute pancreatitis

Death in the life cycle is the final farewell. Palliative care can relieve symptoms, strengthen comfort care, and improve the quality of life at the end of the life of the elderly, patients with malignant diseases and other groups. With the development of the economy, the aging population and the changing needs of various social groups, there are obstacles and difficulties in the practice of palliative care, such as the poor public awareness of palliative care, the lack of palliative care service agencies, the shortage of professional personnel, and deficient law and regulation support. Policies and laws and regulations support defects. This article starts from the necessity of the development of palliative care, analyzes the factors that affect the practice of palliative care, and puts forward countermeasures for the development of palliative care.

Objective: To observe the antiasthmaf ic, anti-inflammatory and immunological effects of Gubenchuansoukang Granule. Methods: The rats asthma model was established by ovalbumin sensitization. The model was identified by the study of the asthma incubation period and the total white cells counts in bronchoalveolar lavage fluid (BALF). The anti-inflammatory effect was observed by the acute inflammation and chronic inflammation induced xylene and agar. To observe the effect of Gubenchuansoukang Granule on humoral immunity and cellular immunity induced by chicken red blood cell and 2, 4-dinitrochlorobenzene. Results: Gubenchuansoukang Granule could lengthen the asthma incubation period, reduce the quantity of total white cells in BALF, against the acute inflammation and chronic inflammation, and restrain the humoral immunity and cellular immunity. Conclusion: Gubenchuansoukang Granule had antiasthmafic, anti-inflammatory and immunosuppression effects.

Objective:To construct an evaluation framework with detailed indices for demonstration units (wards) of enteral nutrition nursing, in order to improve the competence of nurses in enteral nutrition nursing and inform the specialized development of enteral nutrition demonstration units (wards).Method:On the basis of literature review and expert discussion, a preliminary draft was developed, and the Delphi expert consultation method was used to conduct two rounds of consultation with 15 clinical experts in the field of enteral nutrition nursing from 15 tertiary hospitals.Results:The effective response rates of questionnaires in two rounds of consultations were both 100%. The first round of expert consultation showed an authority coefficient of 0.90 and a coefficient of variation of 0 to 0.167, while the second round showed an authority coefficient of 0.93 and a coefficient of variation of 0 to 0.113. The Kendall harmony coefficients were 0.338 and 0.368, respectively. Finally, the evaluation framework with detailed indices for the demonstration unit (ward) of enteral nutrition nursing was formed, which consisted of 3 primary indicators, 16 secondary indicators, 54 tertiary indicators, and 62 detailed items.Conclusions:The evaluation framework we developed for the demonstration unit of enteral nutrition nursing follows the diagnosis and treatment process of enteral nutrition management for inpatients, including the triad of structure, process, and outcome. The framework is objective and practical, and can inform the daily practice of enteral nutrition nursing demonstration units (wards) and the development of enteral nutrition nursing specialties.

Objective:To understand the nutritional nursing competence in the enteral nutrition demonstration wards at this stage, so as to inform subsequent training plan.Methods:From September to October in 2023, nurses from 287 institutions involved in the enteral nutrition demonstration ward construction project were selected using convenience sampling. Questionnaires on general characteristics and self-assessment scale on nutrition nursing competence were used for online survey. The status quo and influencing factors of nutrition nursing competence in included institutions were analyzed.Results:A total of 5 409 valid questionnaires were collected, with a response rate of 62.63%. The total score of nutrition nursing competence was 74.74±16.11, with the least subtotals in the domain of nutrtion knowledge. Multiple linear regression showed that influencing factors of nutrition nursing competence includes years of working, department, registered dietitian or not, nutrition management specialist or not, completion of the curriculum in enteral nutrition demonstration ward construction project, and training/supervision arranged by their department concerning nutrtion nursing and relevant evaluation criteria ( P<0.05). Conclusions:The nutritional nursing competence of clinical nurses in the wards involved in enteral nutrition demonstration ward construction project still needs to be improved. Seniors should take into consideration the varying nutritional nursing competence among junior nurses and nurses from different departments, and strengthen the training on nutrition knowledge. It should be encouraged for nurses to actively participate in nutritionist training. Actions including enhancing nutrition specialist training, establishing the multidisciplinary collaborative nutrition care team and conducting regular supervision and assessment should be implemented in the future, to improve the nutritional nursing competence among nurses.

Magnetic resonance (MR) imaging is an important tool for prostate cancer diagnosis, and accurate segmentation of MR prostate regions by computer-aided diagnostic techniques is important for the diagnosis of prostate cancer. In this paper, we propose an improved end-to-end three-dimensional image segmentation network using a deep learning approach to the traditional V-Net network (V-Net) network in order to provide more accurate image segmentation results. Firstly, we fused the soft attention mechanism into the traditional V-Net's jump connection, and combined short jump connection and small convolutional kernel to further improve the network segmentation accuracy. Then the prostate region was segmented using the Prostate MR Image Segmentation 2012 (PROMISE 12) challenge dataset, and the model was evaluated using the dice similarity coefficient (DSC) and Hausdorff distance (HD). The DSC and HD values of the segmented model could reach 0.903 and 3.912 mm, respectively. The experimental results show that the algorithm in this paper can provide more accurate three-dimensional segmentation results, which can accurately and efficiently segment prostate MR images and provide a reliable basis for clinical diagnosis and treatment.
Male ; Humans ; Prostate/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Magnetic Resonance Imaging/methods* ; Imaging, Three-Dimensional/methods* ; Prostatic Neoplasms/diagnostic imaging*