Objective To summarize the experience of applying choledochoscopy, duodenoscopy and laparoscopy, one-stage suturing of common bile duct, to treat cholecystolithiasis and choledocholithiasis that failed to respond to ordinary endoscopic sphincterotomy (EST). Methods Retrospectively analyzed the clinical data of twenty-five pa-tients with choledocholithiasis complicated with cholecystolithiasis. 25 cases of failure to endoscopic stone extraction underwent LC and laparoscopic common bile duct exploration with primary suture of (BD) from June 2013 to June 2015. Results One patient was converted to laparotomy with small incision. The other one had residual stones and therefore underwent a second EST. After the treatment, two patients developed hyperamylasemia, which was cured by conservative therapy; One patient had bile leakage, which was treated by percutaneous drainage with no serious complications and death. No long-term complication was found in a portion of patients followed up until now. Conclusion In properly selected patients of duodenoscopy management-failed, synchronous treatment of combined application of three endoscopies in laparoscopic surgery with primary suture of (BD) is feasible, effective and safe.

Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.

Objective To observe the effects of radiation on the growth and expression of cysteine-rich 61(Cyr61/CCN1) of L929 cells and investigate the relationship between CCN1 expression and radiation injury.Methods L929 cells were cultured and divided into 2 groups,cells irradiated with 4 Gy ?-irradiation as radio-group and untreated cells as control group.The cell proliferation was measured by MTT assay and plate colony formation testing.Flow cytometry was utilized to quantify the cell cycle distribution.CCN1 expression at protein and mRNA levels were determined by immunocytochemistry(ICC) and RT-PCR respectively.Results Significant inhibition of proliferation(P

Objective To study the role of Cysteine-rich 61 ( Cyr61/CNN1) in repair of combined injury by observing whether exogenous CCN1 promotes the proliferation and migration of radiation-injured L929 cells. Methods A radiation model of L929 cells was induced by ? ray at a dose of 4 Gy. The irradiated L929 cells were cultured in a medium containing 2 ml adenovirus plasmids of CCN1 or RFP at 37 ℃ in an atmosphere containing 5% CO2,which served as a CCN1 group and a RFP group,respectively. Irradiated L929 cells cultured in a blank control medium served as a blank control group. Effects of CCN1 on proliferation and migration of radiation-injured L929 cells were detected by MTT assay,plate colony formation assay,cell cycle analysis,and scratch test of wound healing. Results The proliferation and colony formation rates of L929 cells cultured in a medium containing CCN1 were significantly higher than in RFP and control groups [colony formation rate:( 34. 4 ?3. 6) % vs ( 24. 5 ?2. 9) % and ( 29. 5 ?3. 5) %,P

ObjectiveTo elucidate the association of immune response to hepatitis B vaccination with HLA-DRB1 * 12 allele as well as the level of IL-4 and IFN-γ.MethodsSeventy-four healthy college students from Guangxi province who had non- or hypor -response to recombinant hepatitis B vaccination and 64 medium- or hyper-responders with the conditions of similar were selected randomly and involved in this study.HLA-DRB1 * 12 was detected by PCR-SSP,the level of IFN-γ and IL-4 cytokines were examined by ELISA.Results(1)The allelic frequencies of HLA-DRB1 * 12 was lower in the non- or hypor-responders than that in the medium- or hyper-responders ( 10.8％ vs 32.8％,P=0.002) ; (2)The expression level of IFN-γ in the non- or hypor-responders ( 7.21±7.92 ) ng/ml was much less than that of the medium- or hyper- responders ( 16.36± 11.00) ng/ml ( P=0.000).(3) The expression level of IL-4 in the non- or hyporresponders (3.18±4.45) ng/ml was much less than that of the medium- or hyper- responders (7.76±5.71 ) ng/ml(P=0.000).(4)No significant differences was seen between the expression level of IFN-γ in the HLA-DRB1 * 12 positive ( 13.18± 11.24) ng/ml and the negative ( 11.00± 10.29 ) ng/ml ( P =0.349 ).(5)No significant differences was seen between the expression level of IL-4 in the HLA-DRB1 * 12 positive (5.947±4.530) ng/ml and the negative (5.132±5.800) ng/ml (P=0.423).ConclusionHLA-DRB1 * 12 might be the allele enhanced immune response to hepatitis B vaccination.The expression levels of IFN-γand IL-4 correlating to Thl/Th2 cells might affect on the immune response to hepatitis B vaccination.

Objective:To conduct a scoping review of the characteristics, functions, risk of bias and applications of home-based self-management behavior assessment tools for lung transplant patients, so as to provide references for clinical medical staff to conduct further related research.Methods:The relevant literatures were systematically searched in China National Knowledge Infrastructure, Wanfang Database, VIP, China Biology Medicine disc, PubMed, Web of Science Core Collection, Embase, Cochrane Library and CINAHL databases. The search period was from the establishment of the databases to June 30, 2023. The scoping review method framework was used to screen the literature, extract information and standardize the report.Results:A total of 10 167 Chinese and English literatures were searched, and after deduplication and screening, 23 articles that met the criteria were finally included, involving 13 home-based self-management behavior assessment tools for lung transplant patients, including nine specific tools and four universal tools. There were eight kinds of lung transplantation patients whose reliability and validity were not verified. Of the 13 tools, those with single-dimensional assessments and single measures predominate. The level of home self-management behavior of lung transplant patients was reflected mainly through compliance, and medication management was the most frequently assessed content.Conclusions:At present, the measurement of home-based self-management behavior of lung transplant patients is mainly based on questionnaire surveys, and the evaluation tools are mostly single dimensional. The reliability and validity of most evaluation tools in the population of lung transplant patients are not yet clear, and there is a certain risk of bias. It is recommended that researchers pay attention to the reliability and validity verification report of the evaluation tool in the target population when selecting it, and integrate multiple measurement methods to reduce measurement errors.

Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.

Objective:To explore the nutritional knowledge, attitude and practice (KAP) in patients during the waiting period for lung transplantation, analyze its influencing factors, and provide a reference for individualized nutritional intervention during the perioperative period of lung transplantation.Methods:Totally 240 patients during the waiting period for lung transplantation after lung transplantation evaluation in The Respiratory Center, Wuxi People's Hospital between January and December 2018 were selected using convenient sampling, and investigated with the self-made nutritional KAP questionnaire for patients during the waiting period for lung transplantation. And the influencing factors to their nutritional KAP were analyzed.Results:The nutritional knowledge of patients during the waiting period for lung transplantation was average, with a score of (18.71±4.53) ; the nutritional attitude was good, with a score of (38.00±6.49) ; the nutritional practice was average, with a score of (36.75±4.89) . Multiple linear regression analysis showed that the influencing factors of nutritional knowledge were economic status and whether it was complication with neurological diseases ( P<0.05) ; the influencing factors of nutritional attitude were occupation and serum protein ( P<0.05) ; the influencing factors of nutritional practice were age, educational level and whether it was complicated with urinary system disease ( P<0.05) . Conclusions:The nutritional KAP of patients during the waiting period for lung transplantation is affected by age, economic status, comorbidity, occupation and educational level and serum protein. In the perioperative nutritional management of lung transplantation patients, we should fully consider various factors, provide targeted and precision nutritional interventions, improve the nutritional practice and status of patients by improving their nutritional knowledge and attitude.

Objective To develop a symptoms assessment scale for lung transplant recipients in early postoperative period,and assess its reliability and validity so as to provide clinical staff with a tool to evaluate the symptoms in the patients in the early period after lung transplantation.Methods With a symptom experience model,a preliminary item pool was established through literature reviews,semi-structured interviews and expert panel meetings between December 2021 and January 2022.Based on the preliminary item pool,an initial scale was proposed after two rounds of expert consultation between February and March 2022.The initial scale was finalised after all items had revised for language expression based on the results of cognitive interviews conducted in March 2022.Subsequently,the final version of the scale was applied in the survey of 116 recipients of lung transplant in the early postoperative stage at Wuxi People's Hospital between April 2022 and February 2023.The reliability and validity of scale were then further tested.Results A total of 112 patients responded to the questionnaire survey.The developed scale comprised 5 dimensions:psychology-related symptoms,respiratory related symptoms,digestive related symptoms,circulatory related symptoms and other symptoms,with 18 symptom items in total.Content validity indexes of the Item-level content validity index(I-CVI))were 0.833 to 1.000 and the Scale-level content validity index(S-CVI)was at 0.954.Exploratory factor analysis revealed five common factors with a cumulative variance contribution rate of 82.366%.All the factors exhibited positive correlations with the scale,with the correlation coefficient at 0.760 to 0.837(P<0.01).The scale demonstrated a Cronbach α coefficient of 0.943,and the Cronbach α coefficients of the five common factors ranged from 0.869 to 0.941.Additionally,the scale exhibited a split-half reliability of 0.840,and the split-half reliability of the five common factors ranged from 0.830 to 0.937.Conclusions The symptoms assessment scale for lung transplant recipients in early postoperative period developed in this study exhibits good reliability and validity.It is feasible for evaluation of early symptoms in lung transplant recipients.