Objective: To investigate the cause and preventive measures of positive stump in gastrectomy for gastric cancer. Methods: Nine hundred forty-six patients performed with gastrectomy for gastric carcinoma had been collected from January 1998 to May 2009, the ratio of positive stump was analyzed retrospectively. Results: The rate of positive stump of gastrectomy was 6.24%(59/946). Statistical difference was found between the rate of radical and palliative gastrectomy(P0.05). Conclusion: The rate of positive stump was higher in palliative gastrectomy, Borrmann Ⅲ～IV type, low differentiated cancer and those cases with metastatic lymph nodes more than seven. To prevent the occurrence of positive stump in gastrectomy for gastric cancer, gastroscopy and barium meal should be carried out, enough length between incisal margin and tumor edge should be kept and frozen biopsy should be done.

Objective To investigate the effects of D-tryptophan (D-Trp) on the formation of Streptococcus mutans (S. mutans) biofilm and the dispersal of 24 h-old biofilm, and the drug susceptibility of S. mutans against chlorhexidine (CHX) under the role of D-Trp. Methods Optical density assay was used to evaluate the growth curve of S. mutans exposed to 5.0 mmol/L D-Trp for 28 h. The non-treated group was not added with D-Trp. After treatment with 1.0, 2.5 and 5.0 mmol/L D-Trp, crystal violet staining was used to observe the changes of S. mutans biofilm formation in treatment group and non-treatment group. Crystal violet staining and confocal laser scanning microscopy (CLSM) were applied to illustrate the effects of 1.0, 2.5 and 5.0 mmol/L D-Trp on the dispersal of 24 h-old S. mutans biofilm. Resazurin sodium was used to indicate the effect of 5.0 mmol/L D- Trp on the minimum inhibitory concentration (MIC) and the minimum biofilm inhibitory concentration (MBIC) of treatment groups and negative control group. Results The growth curves of planktonic S. mutans within 28 h was consistent in treatment group and the non-treated group, both attained exponential phase after 4 h and reached stationary phase at 22 h. Notably, when compared with non-treated group, the biomass of S. mutans biofilm was increased with time from 0 to 72 h after treatment with 1.0, 2.5 and 5.0 mmol/L D-Trp. And at the same time point, the biomass was significantly less in each subgroup of treatment group than that of non-treated group (P<0.05). Crystal violet staining demonstrated that values of biomass(OD570)were less in treatment groups treated with 1.0, 2.5 and 5.0 mmol/L D-Trp than those of non-treated group (P<0.01). CLSM also showed that bacteria was adhered to the surface of media intreatment groups treated with 1.0, 2.5 and 5.0 mmol/L D-Trp. The values of biomass were lower in treatment groups than those of non-treated group (P<0.01). The MIC against S. mutans was 0.073 mg/L in both experimental group and negative control group. The values of MBIC were 0.293 mg/L and 2.344 mg/L in experimental group and negative control group, respectively. Under the action of 5.0 mmol/L D-Trp, the MBIC of S. mutans was reduced to 1/8. Conclusion Results indicate that D-Trp may inhibit the formation of S. mutans biofilm and promote the dispersal of biofilm already formed. D-Trp may further help CHX exert its bactericidal activity to S. mutans.

To determine the inhibition of IL-13 by recombinant sIL-13Rα2 in NIH-3T3 fibroblast cells for its potential therapeutic value in hepatic fibrosis caused by Schistosoma japanicum in mice . IL-13 and sIL-13Rα2 from liver of BALB/c mice infected with S.japonicum at different infection time (weeks 0,6,8,10 and 12) were analyzed by ELISA and RT-PCR. The recombinant sIL-13Rα2 expression plasmidwas constructed, followed by transfection into NIH-3T3 fibroblast cells. TypeⅠcollagen produced by NIH-3T3 cells were examined by RT-PCR and Western blotting. It was demonstrated that the expression of IL-13 increased gradually after infection, reached peak density (16.1586 pg/mL)at week 8 and then reduced but was still higher than the level of control mice(3.4146 pg/mL;P =0.017 ). The secretion of sIL-13R α2 reached to its peak 10 weeks after infection(4827.426 pg/mL)and then reduced slowly but still higher than normal(4057.112 pg/mL; P=0.021). Meanwhile, the changes in mRNA level of IL-13 and sIL-13R α2 were coincided with that examined by ELISA. Both IL-13 and sIL-13Rα2 reached their peak density (P=0.033) at week 8 and 10 (P=0.025) respectively, and they were followed by a slower degree of decrease. The sIL-13Rα2 could significantly inhibit the effect of IL-13 on NIH-3T3 fibroblast cells, showing decreased mRNA level(P =0.012)and protein level of typeⅠcollagen compared with normal groups(P =0.031). It is concluded that the sIL-13Rα2 can inhibit the effect of IL-13 on NIH-3T3 fibroblast cells which leads to a reduced production of typeⅠcollagen, demonstrating its potential therapeutic value in hepatic fibrosis of schistosomiasis.

Objective To explore the effect of Omaha system nursing model on nutritional status and disease condition of patients with low body mass and chronic obstructive pulmonary disease (COPD). Methods Sixty COPD patients with low body mass who were admitted to the First Affiliated Hospital of Huzhou University from January 2015 to November 2016 were enrolled, and they were randomly divided into an Omaha system nursing model group and a routine care intervention group, with 30 cases in each group. The Delphi expert consultation method was used to construct the Omaha nursing problem system and intervention system for COPD patients with low body mass. The patients in the routine care intervention group were given routine care intervention; the patients in the Omaha system nursing model group underwent nutritional intervention according to the Omaha system nursing model. The Mini Nutritional Assessment (MNA), COPD Assessment Test (CAT) and the modified Medical Research Council Dyspnea Scale (mMRC) were used to be the evaluation system of the Omaha system nursing model, the changes of MNA, CAT and mMRC evaluation scores on admission and in 1, 3, and 6 months after discharge in the two groups were recorded, and the correlations between MNA score and CAT, mMRC scores were analyzed. Results Omaha system analysis showed that the main health problems of the Omaha system nursing model group were distributed in the environmental (17.86%), social psychological (8.93%), physiological (19.64%), and health-related behavioral (53.57%) aspects, among which health-related behaviors were mostly common. There were no statistical significant differences in the scores of CAT, mMRC, and MNA between the two groups on admission (all P > 0.05). The CAT and mMRC scores of the Omaha system nursing model group in 1, 3, and 6 months after discharge were significantly lower than those on admission (CAT score: 16.98±2.39, 16.67±2.55, 15.36±2.17 vs. 25.76±3.67; mMRC score: 2.35±0.57, 1.97±0.52, 1.49±0.51 vs. 3.07±0.55, all P < 0.05), MNA scores were significantly higher than those on admission (11.89±3.57, 13.97±3.52, 15.49±3.51 vs. 10.33±3.02, all P < 0.05), and along with the prolongation of time the decrease and increase in scores were more significant. The scores of the Omaha system nursing model group were improved more significantly in 1, 3 and 6 months after discharge than those of the routine care intervention group (CAT score: 16.98±2.39, 16.67±2.55, 15.36±2.17 vs. 23.01±2.67, 21.15±2.79, 19.06±2.61; mMRC score: 2.35±0.57, 1.97±0.52, 1.49±0.51 vs. 3.06±0.65, 3.06±0.61, 2.65±0.67;MNA score: 11.89±3.57, 13.97±3.52, 15.49±3.51 vs. 9.96±3.15, 10.06±3.09, 8.55±3.17, all P < 0.05]. Pearson correlation analyses showed that MNA score was significantly negatively correlated with CAT score (r = -0.493, P = 0.001) and with mMRC score (r = -0.594, P = 0.001) respectively. Conclusion Using the Omaha system nursing model for nutrition intervention in COPD patients with low body mass can significantly improve their nutritional status and disease condition as well as quality of life.

Objective: To investigate the characteristics and clinical value of visual evoked potentials(VEP) in children with optic neuritis. Methods: The VEP of 33 children with optic neuritis were tested by NICOLET evoked potential instrument.The results were compared with those of cranial and/or orbital MRI and fundus examination, and the consistency with visual performance was analyzed.The correlation between visual sensitivity and VEP results was analyzed. Results: Among 33 children with optic neuritis, the abnormal rate of VEP in 52 abnormal eyes was 88.5%; the abnormal rate of cranial and/or orbital MRI was 38.5%; the abnormal rate of fundus examination was 62.2%; the abnormal rate of VEP examination was significantly higher than that of cranial and/or orbital MRI and fundus examination (P<0.05); the consistency rate between VEP examination and visual acuity was 84.8%.The consistency rate between pattern reversal visual evoked potential (P-VEP) and visual acuity was 86.8%, and that between flash visual evoked potential (F-VEP) and visual acuity was 82.1%.With the increase of visual impairment, the percentage of P100 wave loss increased gradually.There was no correlation between visual acuity and the prolongation of P100 wave latency. Conclusion There are significant differences between VEP and fundus examination and MRI, the sensitivity of VEP is superior to both.P-VEP is more consistent with visual acuity than F-VEP.VEP has certain value in evaluating the degree of visual impairment in children with optic neuritis.It can not be used to evaluate the level of optic sensitivity when the latency of P100 wave is prolonging.

Acute respiratory distress syndrome (ARDS) is a common cause of death in critically ill patients. At present, the pathogenesis of ARDS has not been clarified, which is mainly related to excessive inflammatory response, increased endothelial and epithelial permeability, and decreased alveolar surfactant. In recent years, many studies have shown that mitochondrial DNA (mtDNA) is involved in the occurrence and development of ARDS by inducing inflammation and activating immune response, and has the potential to be used as biomarkers for ARDS. This article reviews the role of mtDNA in the pathogenesis of ARDS, aiming to provide new strategies for the treatment of ARDS, and ultimately reduce the mortality of ARDS patients.
Humans ; DNA, Mitochondrial ; Mitochondria ; Inflammation ; Permeability ; Respiratory Distress Syndrome

Objective To investigate the change and significance of follicular helper T cells (Tfh) percentage in the peripheral blood of the patients with rheumatoid arthritis (RA).Methods The RA patients treated in this hospital from September to November 2016 were selected and divided into the RA active group and RA stable group,35 cases in each group.Contemporaneous 35 individuals undergoing physical examination were selected as the healthy control group.The percentage of peripheral blood CD4+ CXCR5+ ICOS+ Tfh cells was detected by flow cytometry.The correlations between the percentage of peripheral blood Tfh cells in RA patients with the RA disease activity score 28 (DAS28),anti-CCP antibody and rheumatoid factor(RF) levels were analyzed.Results The percentage of peripheral blood Tfh cells in the RA active group was (0.84±0.16) ％,which was significantly higher than (0.64±0.15)％ in the RA stable group and (0.56±0.14)％ in the healthy control group,the difference was statistically significant (P＜0.01);moreover the percentage of peripheral blood Tfh cells in the RA stable group was also higher than that in the healthy control group (P＜0.05).The percentage of peripheral blood Tfh cells in RA patients had significantly positive correlation with DAS28 score and anti-CCP antibody level (r=0.355,0.324;P＜0.01),and had no correlation with the RF level (r=0.205,P＞0.05).Conclusion The percentage increase of peripheral blood Tfh cells in the patients with RA might be related with the pathogenesis and development of RA.

Objective:To construct the evaluation index system of core competence of extracorporeal membrane oxygenation (ECMO) specialist nurses.Methods:Through literature search and analysis, an entry pool of the core competence evaluation index system for ECMO specialist nurses was initially formed, and 20 medical and nursing experts in acute and critical care and cardiovascular fields were selected for two rounds of correspondence from September to November 2022. According to experts' opinions, the evaluation indexes of core competence of ECMO specialist nurses were modified, and the analytic hierarchy process determined the weights of indexes at all levels.Results:A total of 20 questionnaires were sent out and 20 valid questionnaires were collected during each of the two rounds of expert correspondence consultation, with effective recovery rates of 100.00%. The expert authority coefficient of the second round was 0.86, and Kendall's harmony coefficient was 0.31 ( P<0.01). Finally, the evaluation index system of core competence of ECMO specialist nurses included five primary indexes (clinical professional ability, communication and collaboration ability, nursing management ability, critical thinking ability, and professional development ability), 15 secondary indexes, and 53 tertiary indexes. Conclusions:The evaluation index system of core competence of ECMO specialist nurses constructed in this study is scientific and practical, providing a reference for evaluating ECMO specialist nurses' core competence.

Objective:To explore the research hotspots and development trends of mobile health technology applications among family caregivers using bibliometric methods, providing a reference for related studies.Methods:The Web of Science Core Collection was selected as the data source, and research on mobile health technology in family caregivers published from January 1, 2005, to August 31, 2023, was retrieved. Excel, Scimago Graphica, and CiteSpace software were used to create network maps of countries, institutions, authors, and keywords, exploring research hotspots and development trends in this field.Results:A total of 475 relevant articles were included, showing an overall upward trend in annual publication volume. The United States had the highest publication volume (173 articles), with the most influential author and the institution with the highest publication volume being Sin and the University of Washington, respectively. Current research hotspots included chronic diseases, mental health, and social support, while future research trends focus on in-depth studies, artificial intelligence, and enhancing network information security.Conclusions:Research on the application of mobile health technology among family caregivers is on the rise, mainly focusing on assisting caregivers in managing chronic diseases, improving their mental health, and enhancing their social support. Future research frontiers may include optimizing and refining digital health technologies, using artificial intelligence to predict and alleviate caregiver burden, and enhancing industry regulation and data security.

Objective:To analyze fetoscopic cord laser therapy for management of monochorionic monoamniotic (MCMA) twin pregnancies.Methods:The clinical data of fetoscopic cord laser therapy, including cord occlusion, transection, and disentanglement in three pairs of MCMA twins from January 2020 to January 2021 in Peking University Third Hospital were summarized. Literature on cord occlusion and/or transection in MCMA twins were retrieved from Cochrane Library, PubMed, EMBASE, CBM, WanFang, and CNKI from the time at establishment to December 2020. The clinical conditions, surgical indications and methods, disease progression, and maternal and infant prognosis were analyzed.Results:Three cases of MCMA twins in this study period received fetoscopic cord laser therapy between 17-24 weeks, among which two cases gave birth at full-term without any maternal or infant complications, and one was terminated due to fetal malformation. Seven English articles including 29 MCMA twin pregnancies were retrieved. In addition to the three cases reported in this article, a total of 32 cases were analyzed. The indication of cord occlusion and/or transection included twin-reversed arterial perfusion sequence (21.9%, 7/32), fetal malformation (46.9%, 15/32), selective fetal growth restriction (sFGR) (21.9%, 7/32), twin-to-twin transfusion syndrome (TTTS) (3.1%, 1/32), TTTS combined with sFGR (3.1%, 1/32), single intrauterine death (3.1%, 1/32). Gestational age at surgery was between 14 +1 to 27 +3 weeks. No maternal complication due to the operation was reported. After exclusion of two cases who did not receive cord transection and one case was terminated due to fetal malformation, all the other 29 co-twins were born alive at the gestational age between 24 +3 to 40 weeks and birth weight between 800-3 800 g. Among the 29 live born babies, four died soon after birth with unclarified reasons in the literature and one was born with multiple malformations which were detected prenatally, and the other 24 neonates were healthy during the follow-up from 1 month to 9 years old. Conclusions:For MCMA twin pregnant women with umbilical cord entanglement or other indications for fetal reduction, cord occlusion, transection, and disentanglement using fetoscopic cord laser is safe and effective for protecting the surviving fetus.