Objective To establish a predictive model and to find the preoperative predictors for the nature of lesion in the setting of chronic pancreatitis. Methods The 121 patients from 7 tertiary medical centers in Shanghai from July 1998 to April 2007 with focal mass lesions in the setting of chronic pancreatitis were selected as the study population. The final diagnosis had to be confirmed histologically by surgical specimens (n =97) or by follow-up (n = 24). A case control study was conducted; the patients were divided into pancreatic cancer group and chronic pancreatitis group. The age, sex, past history, initial clinical presentations, lab results and imaging exams were collected by reviewing the medical records of these patients. χ~2 test and t test was used for univariate analysis, then the factors with P≤0. 25 were selected for further multivariate analysis, and multivariate logistic regression model was used to estimate odds ratio and 95% CI. Results Of 121 , 21 patients had a final diagnosis of pancreatic cancer and other 90 patients had a final diagnosis of chronic pancreatitis. Abdominal tenderness, direct bilirubin, CA19-9 and CEA were independent predictors of cancer in patients with focal mass lesions. Their odds ratios (95% CI) were 5. 691 (1.468, 22.070) , 1.011 (1.001 , 1.021) , 1.003 (1.001, 1.005) , 101.9 (0.988, 1.051) , respectively. Their P values were 0. 012, 0. 030, 0.003 and 0. 23 , respectively. Conclusions The logistic regression model may accurately predict the nature of lesion in the setting of chronic pancreatitis and may have certain clinical implication.

Objective:To evaluate the role of interleukin 1β (IL-1β)/c-Jun N-terminal kinase (JNK) pathway in sevoflurane-induced necroptosis of rat hippocampal neurons in vitro. Methods:Primarily cultured hippocampal neurons of Sprague-Dawley rat fetuses were inoculated into 96-well plates (cell density: 1×10 4 cells/ml, 200 μl/hole) and 6-well plates (cell density: 1×10 6 cells/ml, 2 ml/hole). The cells were divided into 3 groups ( n=20 each) using a random number table method after being cultured for 7 days: control group (group C), sevoflurane group (group S) and IL-1 receptor antagonist group (group I). Group C received routine culture, IL-1 receptor antagonist IL-1ra 1 μg/μl was added, and the cells were incubated for 30 min in group I, and in addition the cells were placed in the incubator containing 2% sevoflurane and cultured for 5 h at 37 ℃ in S and I groups.The cells were collected for microscopic examination of the morphology of neurons (with an inverted microscope) and for determination of the cell necroptosis rate (by flow cytometry), cell viability (by MTT method), and expression of IL-1β, interleukin-1 receptor type I (IL-1RI), interleukin-1 receptor accessory protein (IL-1RAcP), phosphorylated JNK (p-JNK) ), receptor-interacting protein 1 (RIP1), RIP3 and phosphorylated mixed lineage kinase-like (p-MLKL) (by Western blot ). Results:Compared with group C, the cell viability was significantly decreased, the necroptosis rate was increased, and the expression of IL-1β, IL-1RI, IL-1RAcP, p-JNK, RIP1, RIP3 and p-MLKL was up-regulated in group S ( P<0.05). Compared with group S, the cell viability was significantly increased, the necroptosis rate was decreased, and the expression of IL-1β, IL-1RI, IL-1RAcP, p-JNK, RIP1, RIP3 and p-MLKL was down-regulated in group I ( P<0.05). There was no obvious abnormality in the morphology of neurons in group C. The cell body of neurons was shrunk, the processes were broken, and the network between processes was sparse in group S. The cell body was round, and the morphology was close to normal in group I. Conclusion:The mechanism by which sevoflurane induces necroptosis of rat hippocampal neurons in vitro is related to activation of IL-1β/JNK pathway.

Objective To quickly screen the risk events of nursing medication, propose comprehensive and targeted preventive measures to guide clinical nursing work, ensure the safety of patient medication, improve the quality of care, and provide a more reliable theoretical framework and basis for the quality management system of drug care. Methods In this retrospective case-control study, totally 688 nursing medication errors reported from a Class Ⅲ Grade A hospital from January 2016 to December 2018 were selected as the case group, and 1376 cases without nursing medication errors were randomly selected as the control group from the drug execution database at the same time. Univariate and multivariate Logistic regression analysis was performed on the objective and human factors related to the occurrence of medication errors to explore the potential risk factors of nursing medication errors and construct a risk prediction model for nursing medication errors. Results Univariate analysis showed that nurses' job title and working years, patients' gender, education level and age, dosing shift, time of shift, working hours, route of administration, and department of drug administration were the influencing factors of error events in nursing medication (P<0.05). Multivariate Logistic regression analysis was used to incorporate nursing years, department, route of administration,patient's age, whether or not in the shift period into the final risk prediction model for nursing medication errors (P< 0.05). The receiver operating characteristic curve (ROC) was drawn and the area under the ROC (AUC) was calculated. The AUC was 0.765, which was > 0.7, showing that the model had sound predictive power in clinical practice. Conclusions The construction of the prediction model for nursing medication errors can provide a theoretical basis for clinical drug care,which is more targeted and practical for the hospital drug care management system and can ensure the safety of nursing.

Objective:To explore the effects of continuing nursing mode based on theory of use and satisfaction in patients with peripherally inserted central catheter (PICC) .Methods:From August 2017 to June 2018, this study selected 400 patients with PICC as subjects in the First Affiliated Hospital of Wenzhou Medical University.All of patients were divided into control group and intervention group with the method of random number table, 200 cases in each group. Control group carried out the routine nursing. Intervention group analyzed the needs of patients for content and form of continuing nursing, and built the PICC continuing nursing intervention plan based on the theory of use and satisfaction. This study compared the incidence of catheter-related and unplanned extubation, self-management ability, nursing satisfaction of patients between two groups after intervention.Results:After intervention, the incidences of catheter-related complications and unplanned extubation of intervention group were 1.5% and 0 respectively lower than those (16.0% and 5.0%) of control group with statistical differences ( P<0.05) . In intervention group, the scores of the daily catheter observation, maintenance compliance, catheter management confidence, exception handling of catheter, information acquisition, motion with catheter, daily life with catheter and total score of self-management ability, and nursing satisfaction of patients were higher than those in control group with statistical differences ( P<0.05) . Conclusions:Continuing nursing mode based on theory of use and satisfaction can reduce the incidence of catheter-related and unplanned extubation in patients with PICC, improve patients' catheter self-management ability as well as nursing satisfaction which is worthy of being widely used in clinical application.

The solute carrier family 12(SLC12)of cation-chloride cotransporters(CCCs)comprises potassium chlo-ride cotransporters(KCCs,e.g.KCC1,KCC2,KCC3,and KCC4)-mediated Cl-extrusion,and sodium po-tassium chloride cotransporters(N[K]CCs,NKCC1,NKCC2,and NCC)-mediated Cl-loading.The CCCs play vital roles in cell volume regulation and ion homeostasis.Gain-of-function or loss-of-function of these ion transporters can cause diseases in many tissues.In recent years,there have been considerable ad-vances in our understanding of CCCs'control mechanisms in cell volume regulations,with many tech-niques developed in studying the functions and activities of CCCs.Classic approaches to directly measure CCC activity involve assays that measure the transport of potassium substitutes through the CCCs.These techniques include the ammonium pulse technique,radioactive or nonradioactive rubidium ion uptake-assay,and thallium ion-uptake assay.CCCs'activity can also be indirectly observed by measuring y-aminobutyric acid(GABA)activity with patch-clamp electrophysiology and intracellular chloride con-centration with sensitive microelectrodes,radiotracer 36Cl-,and fluorescent dyes.Other techniques include directly looking at kinase regulatory sites phosphorylation,flame photometry,22Na+uptake assay,structural biology,molecular modeling,and high-throughput drug screening.This review sum-marizes the role of CCCs in genetic disorders and cell volume regulation,current methods applied in studying CCCs biology,and compounds developed that directly or indirectly target the CCCs for disease treatments.

Objective To investigate the expression of Nanog and its regulatory relationship with MMP-2/MMP-9 proteins in esophageal squamous cell carcinoma(ESCC).Methods We detected Nanog and MMP-2/MMP-9 protein expressions in 127 ESCC tissues and 82 adjacent normal tissues using immunohistochemistry and explored their correlations with the clinicopathological parameters and prognosis of the patients.GEO database was utilized to analyze the pathways enriched with the stemness-related molecules including Nanog,and TIMER online tool was used to analyze the correlations among TβR1,MMP-2,and MMP-9 in esophageal cancer.Results Nanog and MMP-2/MMP-9 proteins were significantly upregulated in ESCC tissues and positively intercorrelated.Their expression levels were closely correlated with infiltration depth and lymph node metastasis of ESCC but not with age,gender,or tumor differentiation.The patients with high expressions of Nanog and MMP-2/MMP-9 had significantly shorter survival time.Bioinformatics analysis showed enrichment of stemness-associated molecules in the TGF-β signaling pathway,and the expressions of MMP-2/MMP-9 and TβR1 were positively correlated.In cultured ESCC cells,Nanog knockdown significantly decreased the expression of TβR1,p-Smad2/3,MMP-2,and MMP-9 and strongly inhibited cell migration.Conclusion The high expressions of Nanog,MMP-2,and MMP-9,which are positively correlated,are closely related with invasion depth,lymph node metastasis,and prognosis of ESCC.Nanog regulates the expressions of MMP-2/MMP-9 proteins through the TGF-β signaling pathway,and its high expression promotes migration of ESCC cells.

Objective To investigate the expression of Nanog and its regulatory relationship with MMP-2/MMP-9 proteins in esophageal squamous cell carcinoma(ESCC).Methods We detected Nanog and MMP-2/MMP-9 protein expressions in 127 ESCC tissues and 82 adjacent normal tissues using immunohistochemistry and explored their correlations with the clinicopathological parameters and prognosis of the patients.GEO database was utilized to analyze the pathways enriched with the stemness-related molecules including Nanog,and TIMER online tool was used to analyze the correlations among TβR1,MMP-2,and MMP-9 in esophageal cancer.Results Nanog and MMP-2/MMP-9 proteins were significantly upregulated in ESCC tissues and positively intercorrelated.Their expression levels were closely correlated with infiltration depth and lymph node metastasis of ESCC but not with age,gender,or tumor differentiation.The patients with high expressions of Nanog and MMP-2/MMP-9 had significantly shorter survival time.Bioinformatics analysis showed enrichment of stemness-associated molecules in the TGF-β signaling pathway,and the expressions of MMP-2/MMP-9 and TβR1 were positively correlated.In cultured ESCC cells,Nanog knockdown significantly decreased the expression of TβR1,p-Smad2/3,MMP-2,and MMP-9 and strongly inhibited cell migration.Conclusion The high expressions of Nanog,MMP-2,and MMP-9,which are positively correlated,are closely related with invasion depth,lymph node metastasis,and prognosis of ESCC.Nanog regulates the expressions of MMP-2/MMP-9 proteins through the TGF-β signaling pathway,and its high expression promotes migration of ESCC cells.

In this paper the adverse reactions of acupoint embedding and its treatment are summarized, including fever, infection, callosity, blood stasis, red swelling, numb swelling, pain, fester, ulcer, etc. It is consi-dered that adverse reactions are induced by the inappropriate operation, special constitution and embedding material. Thus we need to pay attention to standard manipulation, the contraindication, and cautious usage. Symptomatic treatment needs to be implemented timely once adverse reactions occur.