Objective To study the effect of minimally invasive surgery for treatment of cholecystolithiasis together with common bile duet stones.Methods 245 patients suffered from common bile duct stones were admitted and received the therapeutical procedures.All patients were randomly divided into two groups.138 patients in the treatment group treated with minimally invasive surgery;107 patients in the control group treated with the traditional way of laparotomy.Results Compared with the control group,the treatment group showed high cure rate of 97.83%(P＞0.05),low complication rate of 5.19%,short hospital stays of(7.5±2.1)d,less cost of(8 134±1 676)CNY (x2=18.34,t=8.75,6.93,all P＜0.01).Conclusion Minimally invasive surgery had more advantages and wide application for both doctors and patients.

The paper introduces the basic concept of the data set,formulates the basic data set of Traditional Chinese Medicine (TCM) nursing evaluation through the research and analysis on the clinical nursing process and scientific research business requirements,states the design idea,framework and technical route.The data set is established to provide a common data exchange specification for the nursing evaluation information system,and lay a foundation for the establishment of regional information platform.

Objective: By a statistical analysis and summary of the literature on Traditional Chinese Medicine (TCM) nursing technology published in the core nursing periodical, research the currect status of TCM nursing technology. Methods: Retrieved CNKI database (CNKI) and Wanfang medical journal database,according to Chinese Journal Citation Report (2017 edition) of China Institute of science and Technology Information Research, Choose 10 core nursing periodicals and retrieve the experimental articles related to TCM nursing technology from January 1,2013 to January 1, 2019.this paper analyze time, resources, authors, fund-sponsored researches, statistical methods by bibliometrics analysis. Results: A total of 624 papers were included,of which 132 were in 2013 and 124 in 2014, 103 in 2015, accounting for 57.5%. "Nursing Research" contains 227 articles, 100 "Chinese Journal of Modern Nursing, 98 "Journal of Nursing", accounting for 68.1%. The literature has been published in 28 provinces and cities, 117 in Jiangsu Province, 100 in Guangdong Province, and 89 in Shanghai, accounting for 62.6%. The source of funds for fund papers is mainly provinces and cities, accounting for 38.4%. Involving 22 TCM nursing technology operations, 762 applications, 174 acupoint massage, 113 auricular point application, 109 acupoint points, and 106 moxibustion methods, accounting for 66.3%. There are more than 120 types of diseases involved, mainly cancer, stroke, hypertension, and diabetes. There are more than 180 kinds of symptoms, mainly about pain, constipation, quality of life and so on. Conclusion TCM nursing research has made great progress, TCM nursing technology is currently widely used in clinical practice. Scientific research has also confirmed its effectiveness, but it lacks high-quality core papers. At the same time, due to the diversity of research content, there is a lack of evidence-based nursing research literature.

Objective　To analyze the composition, population density, seasonal trends, and insecticide resistance monitoring results of vector mosquitoes in Liaocheng City from 2020 to 2022, providing a reference basis for further mosquito control measures. Methods　According to the "Implementation Plan for National Vector Biomonitoring", adult mosquito monitoring was carried out using mosquito traps and double-layer stacked nets at two national level monitoring points in Dong’e and Chiping. The Bretu Index method was used for monitoring throughout the city, and the immersion method was used for monitoring mosquito insecticide resistance. The monitoring period for adult mosquitoes was from March to November, and for juvenile mosquitoes was from May to October. Results　From 2020 to 2022, a total of 816 mosquito traps were deployed, capturing 4 717 adult mosquitoes with an average density of 5.78 mosquitoes per trap-night. Among them, 4 232 were Culex pipiens pallens, accounting for 89.72% of the total mosquito population, followed by 15 were Anopheles sinensis, accounting for 0.32%; 10 Aedes albopictus, accounting for 0.21%; 460 other mosquito species, accounting for 9.75%. Mosquito density was higher in rural areas compared to urban areas, with the highest density found in livestock sheds, followed by parks, hospitals, farms, and residential areas. Adult mosquito was first observed in May, with the peak activity occurring from June to August. The double-layer net method captures only Aedes albopictus, with an average net trapping index of 2.99 mosquitoes/(net·h), and their activity was concentrated from June to September. The average Brayton Index (BI) from May to October was 15.95, with a peak occurring in July and gradually decreasing after August. Insecticide resistance monitoring found that Culex pipiens pallens in Liaocheng City exhibited low resistance to permethrin, deltamethrin, dithion, and beta cypermethrin, with beta cypermethrin having the highest resistance. Conclusion　The dominant mosquito species in Liaocheng City is Culex pipiens pallens, followed by Aedes albopictus. The peak activity of adult and juvenile mosquitoes is concentrated between July and September, showing a distinct seasonal trend of growth and decline, posing a risk of dengue fever outbreaks. Culex pipiens pallens exhibits resistance to some insecticides, and timely measures should be taken to prevent the outbreak of mosquito-borne infectious diseases.

Objective:To study the effect of 3-n-butylphthalide (NBP) on the expression of brain-derived neurotrophic factor (BDNF) in the hippocampal CA1 region of the vascular dementia (VD) rats,and to explore its protective effect on VD.Methods:Eighty healthy Wistar rats were equally and randomly assigned to sham operation group,NBP control group (sham operation + NBP injection),VD group (VD models),NBP treatment group (VD models + NBP injection) (n=20).Each group was divided into four subgroups (n =5):1,2,4,and 8 weeks after operation groups.The VD rat models were established by using permanent bilateral common carotid artery ligation.After consciousness,the rats in NBP treatment group and NBP control group were intraperitoneally injected with 5 mg · kg-1 · d-1 NBP for consecutive 7 d.The rats in VD and sham operation groups were intraperitoneally injected with 0.2 mL · d-1 saline for consecutive 7 d.At 1,2,4,and 8 weeks after operation,the rats in each group were decapitated.The brains were obtained,and then the hippoeampus tissues were isolated.The BDNF expression levels in the hippocampal CA1 region were determined using real-time quantitative PCR and immunohistochemistry methods.Results:At 2,4,and 8 weeks after s operation,the expression levels of BDNF mRNA in the hippocampus of the rats in VD group were significantly higher those in sham operation group (P＜ 0.05);at 4 and 8 weeks after operation,the expression levels of BDNF mRNA in the hippocampus of the rats in NBP treatment groups were significantly higher than that in VD group (P＜ 0.05).The immunohistochemistry results showed that the expression level of BDNF protein in the hippocampal CA1 region of the rats in VD group was higher than that in sham operation group at 4 weeks after operation (P＜ 0.05);the expression level of BDNF protein in the hippocampal CA1 region of the rats in NBP treatment group was higher than that in VD group at 8 weeks after operation (P＜0.05).Conclusion:The BDNF expression is increased in the hippocampal CA1 region of the rats with VD after the neurons were injured by ischemia.NBP can increase the BDNF expression level in the hippocampal CA1 region of the VD rats and protect the nerves.

Trauma is recognized globally as a great public health challenge.It stands as the predomi-nant cause of mortality among those under the age of 45 and is also ranked among the top five causes of death for both urban and rural populations within China.This stark reality underscores the critical urgen-cy in establishing an efficient system for trauma care,which is pivotal for substantially enhancing the sur-vival rates of patients.An optimally developed system for trauma care not only guarantees that patients promptly receive professional medical assistance but also facilitates significant improvements in the out-comes of trauma care through the strategic establishment of trauma centers.At present,a considerable variation exists in the quality of trauma care provided across various regions within China.The adoption of comprehensive quality management strategies for the medical processes involved in trauma care,alongside the standardized management of on-site rescue operations,pre-hospital emergency care,and in-hospital treatment protocols,stands as a fundamental approach to boost the capabilities of trauma care and,conse-quently,the survival rates of trauma patients.Serving as the cornerstone of comprehensive medical quali-ty management,key quality control indicators possess the capacity to steer the development direction of trauma centers.In a concerted effort to further augment the medical quality management of trauma care,standardize clinical diagnosis and treatment methodologies,and advocate for the standardization and ho-mogenization of medical services,the Medical Quality Control Professional Committee of the National Center for Trauma Medicine has undertaken a detailed refinement and update of the 16 key quality control indicators for trauma centers.These were initially put forward in the"Notice on Further Enhancing Trau-ma Care Capabilities"disseminated by the National Health Commission in 2018.Consequent to this en-deavor,a revised set of 19 quality control indicators has been devised.This comprehensive set,inclusive of the indicators'names,definitions,calculation methodologies,significance,and the subjects for quali-ty control,is designed for utilization within the quality management and control operations of trauma cen-ters across various levels.This initiative aims to furnish a concrete and executable roadmap for the quality control endeavors of trauma centers.Through the enactment of these quality control indicators,medical institutions are empowered to conduct more stringent monitoring and evaluative measures across all facets of trauma care.This not only facilitates the prompt identification and rectification of existing challenges but also substantially boosts the efficiency of internal collaboration.It enhances the synergy between dif-ferent departments,thereby markedly improving the efficiency and quality of trauma care.

Objective To investigate the role and potential mechanisms of tumor necrosis factor alpha-inducible protein 8-like molecule 1(TNFAIP8L1)in acute liver injury in mice.Methods The second generation of C57BL/6J male wild-type(WT)mice and the C57BL/6J female TNFAIP8L1+/-mice and WT mice were selected to further self-breed the third generation of male TNFAIP8L1-/-mice and the third generation of WT male mice.Five normal third-generation male WT mice and five normal third-generation male TNFAIP8L1-/-mice were selected.The serum alanine aminotransferase(ALT)levels of the two types of normal mice were measured and compared.The infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of normal mice were observed after hematoxylin & eosin(HE)staining.Flow cytometry was used to detect the percentages of neutrophils(Neu),eosinophils(EOS),dendritic cells(DC),bone marrow-derived macrophages(BMDMs),and bone marrow-derived mononuclear cell(BMNCs)in the liver myeloid cell subsets of the two types of normal mice.Another 5 third-generation male WT mice and 4 third-generation male TNFAIP8L1-/-mice were selected to induce acute liver injury mouse models using lipopolysaccharide(LPS)/D-galactosamine(D-Gal).After 24 hours,the serum ALT levels of the two types of acute liver injury mice were detected and compared,the infiltration of inflammatory cells and cell necrosis in the liver tissues of the two types of acute liver injury mice were observed,and the percentages of Neu,EOS,DC,BMDMs and BMNCs in the liver myeloid cell subsets of the two types of acute liver injury mice were measured by using the above methods.Results There was no significant difference in the percentages of Neu,EOS,DC,BMDMs and BMNCs,and serum ALT levels in the livermyeloid cell subsets of normal WT mice and TNFAIP8L1-/-mice(P＞0.05).HE staining results of liver tissues in normal WT mice and TNFAIP8L1/mice showed that hepatic lobules were structurally complete and clear,hepatocytes were morphologically normal and arranged neatly,and there was no obvious inflammatory cell infiltration or cell necrosis.Twenty-four hours after acute liver injury,the percentages of Neu and BMNCs in the liver myeloid cell subsets and the serum ALT levels in the liver tissues of TNFAIP8L1-/-mice were significantly higher than those of WT mice(P＜0.05);there was no significant difference in the percentages of EOS,DC and BMDMs in the liver myeloid cell subsets of mice between the two groups(P＞0.05).In the liver tissues of WT mice with acute liver injury,hepatic lobules were structurally blurred,hepatocytes were swollen with scattered vacuolated steatosis,and a small amount of inflammatory cells were infiltrated.In the liver tissues of TNFAIP8L1/mice with acute liver injury,hepatic lobules were structurally non-existent,and hepatocytes were severely damaged and extensively necrotic,with a large amount of inflammatory cell infiltration.Conclusion The deficiency of the TNFAIP8L1 gene in mice does not affect the development of liver myeloid cells and the homeostasis of the liver.TNFAIP8L1 plays an inhibitory role in the occurrence and development of acute liver injury.TNFAIP8L1 gene deficiency aggravates LPS/D-Gal-induced acute liver injury,possibly by increasing Neu and BMNCs infiltration and recruiting other types of immune cells to infiltrate liver tissues,thereby exacerbating liver cell necrosis.

Objective:To evaluate the effect of esketamine combined with ultrasound-guided dorsal penile nerve block (DPNB) on negative postoperative behavioral changes (NPOBCs) in pediatric patients undergoing circumcision under general anesthesia.Methods:One-hundred and ninety-five pediatric patients, aged 4-8 yr, with body mass index of 10-35 kg, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, undergoing elective circumcision under general anesthesia, were selected and divided into 3 groups ( n=65 each) using a random number table method: esketamine group (group E), DPNB group (group D) and esketamine combined with DPNB group (group ED). Propofol 1.5 mg/kg was intravenously injected, and the patients were admitted to the operating room after consciousness disappeared in the 3 groups. Esketamine 0.5 mg/kg was intravenously injected in E and ED groups, and the equal volume of normal saline was given in group D. D and ED groups underwent bilateral DPNB with 0.25 % ropivacaine 0.15 ml/kg under ultrasound guidance, with the maximum total amount of the drug not exceeding 10 ml. Fentanyl 1.0 μg/kg and propofol 2.0 mg/kg were intravenously injected prior to the skin incision in the three groups. If intraoperative body movement occurred, propofol 10 mg was added, which could be repeated. The occurrence of intraoperative body movement, respiratory depression and amount of propofol added was recorded. When postoperative pain (FLACC score >4) occurred, flurbiprofen 1 mg/kg was intravenously injected for analgesia, and the usage of flurbiprofen was recorded. When emergence agitation(PEAD score>10) occurred, propofol 1 mg/kg was intravenously injected for sedation, and the occurrence of emergence agitation was recorded. Parents were followed up by telephone at 1, 7 and 30 days postoperatively to assess the occurrence of NPOBCs using the PHBQ scale. Results:Fifty-six patients in group E and 59 patients in D and ED groups finally completed the study.Compared with group E, the incidence of intraoperative body movement was significantly decreased, the amount of additional propofol was reduced, the emergence agitation score, incidence of emergence agitation and severe agitation and usage rate of postoperative flurbiprofen were decreased, and the incidence of separation anxiety at 7 and 30 days postoperatively was decreased in D and ED groups, and the incidence of intraoperative respiratory depression was significantly decreased, and the incidence of NPOBCs at 7 and 30 days postoperatively was decreased in group ED ( P<0.05). Compared with group D, the incidence of intraoperative respiratory depression was significantly decreased, the amount of additional propofol was decreased, the usage rate of postoperative flurbiprofen and incidence of sleep anxiety at 1 day postoperatively were decreased ( P<0.05), and no significant change was found in the incidence of NPOBCs at each time point after operation in group ED ( P>0.05). Conclusions:Esketamine combined with ultrasound-guided DPNB can reduce the occurrence of NPOBCs in pediatric patients undergoing circumcision under general anesthesia.