Child ; Electroencephalography ; Epilepsy ; diagnosis ; Humans ; Syndrome ; Video Recording

Objective To explore the influences of doctor-nurse collaboration on job satisfaction and turnover intention among nurses in stomatological hospital. Methods A total of 545 nurses from grade Ⅲ-A stomatological hospital were investigated by convenience sampling method from January 2015 to February 2015 using general data questionnaire, doctor-nurse collaboration scale, nurses′ job satisfaction scale and turnover intention questionnaire. Results The scores of doctor-nurse collaboration scale, job satisfaction and turnover intention were (86. 46 ± 14. 52), (136. 08 ± 14. 88) and (20. 31 ± 3. 67). The doctor-nurse collaboration level was positively correlated with job satisfaction (r=0. 328, P<0. 01) and negatively correlated with turnover intention (r= -0. 220, P<0. 01). Doctor-nurse collaboration level could be positive to predict the situation of job satisfaction (t=2. 871, P <0. 01), and negative to predict the possibility of quitting current job (t =-6. 209, P < 0. 01). Conclusions The situation of nurse job satisfaction and turnover intention is not optimistic in stomatological hospital. Improving the level of doctor-nurse collaboration can help to improve job satisfaction and reduce turnover intention.

Objective To evaluate the efficacy of the suspended overlength biliary stents modified from nasobiliary tube for prevention of duodenobiliary reflux. Methods Suspended overlength biliary stents were placed in the intrahepatic bile duct of 18 patients with extrahepatic bile duct stricture who underwent biliary stents implantation once or more via ERCP from February 2014 to May 2016.Data of these patients were followed up to June 30, 2017 with self-control method. The patency time of suspended overlength biliary stents was compared with the ordinary biliary stents which were implanted in the last ERCP. Incidence of complications was recorded.Results Eighteen patients were enrolled in the study, but one patient lost follow-up. Finally 17 patients were enrolled in the analysis. Nine patients were malignant and 8 benign biliary stricture. The median patency time of suspended overlength biliary stents was 210 days, which was much longer than that of ordinary stents with median patency time of 139 days(P＝0. 015). The median patency time of overlength biliary stents and metal stents in 3 patients with malignant stricture were 278 days and 205 days (P＝1. 000). The median patency time of overlength biliary stents and traditional plastic stents in 6 patients with malignant stricture were 156 days and 65 days, respectively(P＝0. 049). The median patency time of this innovative stents was prolonged in benign biliary stricture patients (254 days VS 143 days, P＝0. 025). Only one patient developed mild pancreatitis after ERCP. Conclusion Suspended overlength biliary stents can prolong the patency time without increasing postoperative complications, which is worth popularization.

Objective:To compare the changes of biliary microbiota after enteral extended biliary stents (EEBS) implantation with that of conventional plastic stents in animal experiment, and to preliminarily investigate its possible mechanism in preventing stents occlusion.Methods:A total of 12 healthy Bama minipigs were randomly assigned to the conventional plastic stent group ( n=6) and the EEBS group ( n=6) using simple random method. The bile samples of all pigs were collected before stents implantation and 4 weeks after stents placement. The biliary microbiota composition and diversity before and after different stents implantation were analyzed by 16S rRNA gene sequencing and compared. Results:No complications including acute cholangitis, perforation, bleeding, or death occurred in 12 pigs. Eight days after stents implantation, stents were out of bile duct in all pigs under endoscopy, while the bile samples were collected again for analysis. The main composition of biliary microbiota at the phylum level were Proteobacteria, Firmicutes and Bacteroidota. Alpha-diversities revealed the Shannon ( P=0.004) and Simpson index ( P=0.008) significantly decreased in the conventional stent group after stents placement, and Bata diversity analysis also showed a significant difference in microbial composition (Anosim: R=0.514 8, P=0.011). There was no significant difference in Observed species index ( P=0.095), Chao1 index ( P=0.136), Shannon index ( P=0.353), Simpson index ( P=0.227) or Bata diversity (Anosim: R=0.059 3, P=0.187) in the EEBS group before and after stents placement. LEfSe algorithm indicated Bacteroides_ fragilis and Proteobacteria- Gammaproteobacteria- Enterobacterales- Enterobacteriaceae- scherichia_ Shigella- Escherichia_ coli significantly increased in the conventional stent group, and Desulfobacterota- Desulfovibrionia- Desulfovibrionales- Desulfovibrionaceae- Bilophila significantly increased in the EEBS group after stents placement. Conclusion:The biliary microbiota change slightly after EEBS implantation in the short-term, and EEBS may prevent duodenobiliary reflux by prolonging the reflux path.

BACKGROUNDHelicobacter pylori (Hp) is a common and potentially curable cause of gastric mucosa lesion. This study investigated the relationship of Hp infection with histological changes in gastric mucosa and gastric cancer in Hp-positive patients compared with Hp-eradication patients followed up for ten years.

METHODSFrom an initial group of 1 006 adults, 552 Hp-positive subjects were randomly assigned to a treatment group (T; n = 276) or a placebo group (P; n = 276). In the randomized, double-blind, placebo-controlled, parallel trial, T group subjects received oral doses of omeprazole, amoxicillin and clarithromycin for 1 week; those in the P group received a placebo. One month after treatment ended, a 13C urea breath test was performed, and Hp was undetectable in 88.89% of the T group. All subjects were followed at 1, 5, 8, and 10 years after treatment, with endoscopy and biopsies for histological examination.

RESULTSGastric mucosa inflammation was significantly milder in the T group than that in the P group one year after Hp eradication and this persisted for 10 years. Glandular atrophy and intestinal metaplasia (IM) had deteriorated in both groups during ten years. However, the increased score of glandular atrophy at both the gastric antrum and corpus, and IM only at the gastric antrum, in the P group was more obvious than that in the T group. During the 10 years, 9 patients were diagnosed with gastric cancer (2 in the T group; 7 in the P group; P = 0.176). When mucosal atrophy was absent at the gastric antrum and corpus when entering the study, the incidence of gastric cancer in the P group (n = 6) was much higher than that in the T group (n = 0, P = 0.013).

CONCLUSIONSHp eradication may significantly diminish and help halt progression of gastric mucosal inflammation and delay the development of IM and atrophy gastritis. Hp eradication is helpful for reducing the risk for gastric cancer, especially in the early stage of Hp infection.

Adult ; Aged ; Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Clarithromycin ; therapeutic use ; Double-Blind Method ; Female ; Follow-Up Studies ; Gastric Mucosa ; drug effects ; pathology ; Gastritis, Atrophic ; diagnosis ; drug therapy ; Helicobacter Infections ; drug therapy ; Helicobacter pylori ; pathogenicity ; Humans ; Male ; Middle Aged ; Omeprazole ; therapeutic use ; Stomach Neoplasms ; diagnosis ; prevention & control