ObjectiveTo review the management and prevention of stenosis after hepaticojejunostomy. MethodsWe retrospectively analyzed 133 patients who developed stenosis after hepaticojejunostomy carried out for iatrogenic bile duct injuries. ResultThrough our active reoperative protocol, we were able to achieve satisfactory results in 131 patients, although the results were still unsatisfactory in 2 patients. ConclusionsStenosis after hepaticojejunostomy is a severe complication which should actively be prevented. Once it happens, doctors should apply active, appropriate and effective measures to correct the stenosis.

Objective: To evaluate the effect of epigallocatechin gallate (EGCG) on T helper cell 1 (Th1) and Th2 in psoriasis patients. Methods: A total of 33 patients with plaque-type psoriasis vulgaris were enrolled, and peripheral blood mononuclear cells (PBMC) were isolated and cultured. The appropriate concentration of EGCG was determined by methyl thiazol tetrazolium (MTT) assay. PBMC at exponential growth phase were divided into 2 groups to be treated with EGCG (EGCG group) or not (control group) for 24 hours. Flow cytometry was performed to determine proportions of Th1 and Th2 cells, enzyme-linked immunosorbent assay (ELISA) to detect levels of Th1 (interleukin[IL]-2, interferon[IFN]-γ) and Th2 cytokines (IL-4, IL-10) in the cell culture supernatant, and real-time quantitative RCR (qRT-PCR) to determine the mRNA expression of T-bet (a Th1 transcription factor) and GATA3 (a Th2 transcription factor) . Statistical analysis was carried out by using t test. Results: According to the MTT assay results, EGCG at a non-toxic concentration of 60 μmol/L was chosen for subsequent experiments. Compared with the control group, the EGCG group showed significantly decreased number of Th1 cells (t = 3.43, P = 0.026) , increased number of Th2 cells (t = 6.68, P = 0.026) , and decreased Th1/Th2 ratio (P < 0.05) . The levels of IL-2 and IFN-γ in the culture supernatant of PBMC were both significantly lower in the EGCG group (824.45 ± 101.21 ng/L, 1 623.62 ± 185.56 ng/L respectively) than in the control group (1 568.32 ± 196.45 ng/L, 3 287.63 ± 235.54 ng/L respectively) , while the levels of IL-4 and IL-10 were significantly higher in the EGCG group (389.48 ± 46.63 ng/L, 285.95 ± 53.28 ng/L respectively) than in the control group (225.38 ± 26.92 ng/L, 165.46 ± 32.25 ng/L respectively) . Compared with the control group, the EGCG group showed significantly decreased T-bet mRNA expression (t = 11.99, P < 0.001) , but increased GATA3 mRNA expression (t = 18.62, P < 0.001) . Conclusion EGCG can reduce the number of Th1 cells, inhibit the production of Th1 cytokines and transcription factors, and increase the number of Th2 cells and the production of Th2 cytokines and transcription factors, followed by the modulation of Th1/Th2 immune imbalance.

OBJECTIVETo explore a more optimal therapy for intractable insomnia.

METHODSSeven hundred cases of intractable insomnia that were in accordance with the criteria were randomly divided into an observation group (368 cases) and a control group (332 cases). The acupuncture prescription of regulating yin-yang and five viscera was applied in the observation group, where Dazhui (GV 14), Shenmai (BL 62), Guanyuan (CV 4), Zhaohai (KI 6), Geshu (BL 17), etc. were selected. The acupuncture prescription of tranquilizing mind was applied in the control group, where Baihui (GV 20), Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyin jiao (SP 6) were selected. The treatment was given once a day, ten times of which made a session. After the treatment for 4 sessions, the clinical efficacy and Pittsburgh sleep quality index (PSQI) were compared between two groups.

RESULTSThe total effective rate was 92.6% (338/365) in the observation group, which was superior to 73.1% (242/331) in the control group (P < 0.05). The PSQI score was obviously decreased in two groups after the treatment (both P < 0.05), in which the decreasing in the observation group was superior to that in the control group (P < 0.05).

CONCLUSIONThe acupuncture prescription of regulating yin-yang and five viscera has better effect for intractable insomnia, which could be considered as a more optimal therapy.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

This paper reviewed research tools of pressure, pressure source, signs and symptoms, and coping styles of male nurses. Effective strategies for male nurses to cope with stress had been proposed, to instruct male nurses to master and apply pressure management methods, improve mental health, and provide basis for managers to take countermeasures at the same time.

This paper summarizes the concept of male nurses' willingness to quit and tools for measuring the willingness to quit. It is suggested there are three aspects to reduce the turnover rate of male nurses: individual factors; social supporting factors; and organizational management factors. Comprehensive interventions, such as, using professional training to cope with the impact of transition shock on the psychological capital of male nurses, creating supportive atmosphere to reduce adverse factors, building a humanized management platform, establishing pre-cognitive male nurses' separation management mechanism, and understanding the turnover intention of male nurses in time, were studied to retain male nurses.

Objective To filter appropriate mouse model for avian influenza viruses with different pathogenicity.Methods Two varieties mice (C57BL/6 and BALB/c) were anesthetized with ketamine and inoculated intranasal with highly pathogenic avian influenza virus H7N9 and low pathogenic avian influenza virus H9N2 in 50 μl PBS,or mock inoculated with PBS to serve as controls.The mice were observed daily including clinical symptoms body,weight and mortality.The pulmonary histopathological changes and viral load were also monitored.Results Just one day after the viral inoculation,H7N9 and H9N2 infected mice strains all showed reduced activity,ruffled fur and obvious body weight loss.The body weight loss nadir in BALB/c mice (63.80％ for H7N9/BALB/c;66.35％ for H9N2/BALB/c) were lower comparing to the corresponding viruses infected C57BL/6 mice (68.96％ for H7N9/C57BL/6 and 87.57％ for H9N2/ C57BL/6 respectively).In addition,there were some obvious pulmonary oedema,haemorrhage and typical pulmonary interstitial inflammatory lesions in the lung tissues.The peak viral load in H7N9/C57BL/6 group (1.02 × 105 copies/ml) was 12 folds higher than that in H7N9/BALB/c group (8.7 × 103 copies/ml).But on the contrary,the peak viral load in H9N2/BALB/c group (2.86 × 104 copies/ml) was 5 times of that in H9N2/C57BL/6 group (5.94 × 103 copies/ml).Conclusions Pathogenic characteristics caused by different virulent avian influenza viral strains could be more clearly differential represented in C57BL/6 mice model,and thus it is more suitable for the comparative study between different pathogenic avian influenza viruses.It also reconfirmed that the different pathological changes and clinical outcomes of avian influenza viruses/mice infection models were associated not only to the different biological characteristics of inoculated virus strains,but also to hereditary characters of host mice strains.

Objective To understand influence factors of the demission of extra-organizational nurses in Shanghai and measures taken by nursing managers for their demission.Methods In-depth qualitative interviews were carried out in 6 included hospital human resource directors of nursing department in Shanghai from August to November 2016 with the method of purposive sampling. Information was collected, transcribed and the themes were extracted.Results Nursing managers in Shanghai considered that the main 3 aspects of influence factors of the demission of extra-organizational nurses should be the lack of social support system, the increase of nursing professional pressure and the limitation of personal career development. The 6 themes of countermeasures taken by managers included: fading the concept of extra-organizational nurses and organizational nurses; reducing the influence of majeure factors; improving the social status of nurses; strengthening the nurse training; strengthening the humanistic care; using the incentive mechanism.Conclusions Nursing managers in Shanghai think that the demission of extra-organizational nurses is influenced by various factors. Nursing managers can adopt positive and effective measures to reduce the nurses' demission.