Objective:To explore the feasibility, safety, and effectiveness of a novel suture instrument for closure of full thickness defects of the gastric wall under gastroscopy.Methods:Ten pigs were used as experimental animals. Perforation model (30 mm in long diameter) was created in the stomach of each pig. The perforations were then closed by the novel suture instrument under gastroscopy. The completion time and efficacy of each perforation repair were recorded. The pigs were euthanized 14 days after the procedure. The healing condition was observed under gastroscopy. A postmortem examination was performed to observe the abdominal infection and healing condition of perforation. Ascites sample was taken for bacterial culture.The stomach biopsy were taken for histopathologic examination.Results:All gastric perforation models in the 10 pigs were established successfully. Endoscopic closure for the stomach perforation was technically successful in all 10 pigs. The procedure time was 34.10±10.32 minutes. All animals survived. Gastroscopy and necropsy showed that the perforation healed well with local adhesion. One pig developed abdominal infection. Ascites culture were negative in 9 cases, 1 bacterial infection was caused by Arcanobacterium pyogenes and Escherichiacoli. The pathology results showed that the muscular layer of the gastric wall defect in the entire group was well repaired. Conclusion:The novel suture instrument is safe and effective in repairing full-thickness gastric wall defects under ordinary single clamp gastroscopy, providing an experimental basis for further clinical research.

Objective:To explore the feasibility, safety, and effectiveness of a novel suture instrument for closure of full thickness defects of the gastric wall under gastroscopy.Methods:Ten pigs were used as experimental animals. Perforation model (30 mm in long diameter) was created in the stomach of each pig. The perforations were then closed by the novel suture instrument under gastroscopy. The completion time and efficacy of each perforation repair were recorded. The pigs were euthanized 14 days after the procedure. The healing condition was observed under gastroscopy. A postmortem examination was performed to observe the abdominal infection and healing condition of perforation. Ascites sample was taken for bacterial culture.The stomach biopsy were taken for histopathologic examination.Results:All gastric perforation models in the 10 pigs were established successfully. Endoscopic closure for the stomach perforation was technically successful in all 10 pigs. The procedure time was 34.10±10.32 minutes. All animals survived. Gastroscopy and necropsy showed that the perforation healed well with local adhesion. One pig developed abdominal infection. Ascites culture were negative in 9 cases, 1 bacterial infection was caused by Arcanobacterium pyogenes and Escherichiacoli. The pathology results showed that the muscular layer of the gastric wall defect in the entire group was well repaired. Conclusion:The novel suture instrument is safe and effective in repairing full-thickness gastric wall defects under ordinary single clamp gastroscopy, providing an experimental basis for further clinical research.

Objective To explore the effects of applied course reform of emergency critical care nursing on self-directed learning ability of nursing students. Methods From September 2016 to January 2017, a total of 180 nursing undergraduates from Xi'an Peihua University of grade 2014 were selected as the research subjects. 86 students from 3 classes were randomly recruited into control group, and 94 students from other 3 classes to observation group. Control group was treated with traditional teaching methods, while experimental group adopted the applied course reform of emergency critical nursing. Nursing students' self-directed learning ability was compared between the two groups before and after the course. Results After the whole course, the total score of students' self-directed learning, learning motivation,planning and implementation,self management and interpersonal communication dimensions were(78.31±8.15), (23.94±3.06),(23.09±2.77), (15.51±2.13) and (15.78±2.04) , which were all higher than (73.37±9.91), (22.79±3.61), (21.72±3.38), (14.28±2.38), (14.58±2.59) in the control group respectively. The differences were statistically significant(t=-3.611, -2.301, -2.970, -3.661, -3.458; P< 0.05). The final exam score of the experimental group was (84.57±8.21), which was higher than that in the control group (81.40±8.07), with a statistically significant difference (t=2.616, P=0.007).Conclusions Applied course reform of emergency critical nursing care can enhance nursing undergraduates' self-directed learning ability.

Objective To investigate the gender differences and psychological influencing factors for anal rectal function in senile patients with functional constipation (FC) .Methods The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group by anorectal manometry and psychological testing methods .Results The anal pressure drops of analog defecation of elderly female and male patients were attenuated and the rectal sensation thresholds increased compared with that of control group ,and the maximal squeezing pressure ,the rectal defecation pressure and anorectal pressure difference of elderly female patients were attenuated compared with that of elderly male patients .The SAS and SDS stand‐ard score of elderly female and male patients were significantly higher than that of control group .The SAS standard score of elderly female patients were higher than elderly male patients .SAS and SDS were negatively correlated with anorectal pressure difference and positively correlated with rectal first sensation volume (FSV) .Conclusion Anorectal dysfunction and psychological factors were involved in the elderly FC pathogenesy ,and they were related .Elderly female patients suffered more severe anxiety and anorectal motility disorders than male patients .

Objective To investigate the gender differences of anal rectal function and depression and/or anxiety in elderly patients with functional constipation (FC).Methods Twenty-seven elder female FC patients (elder female patients group),20 elder male FC patients (elder male FC patients group),28 elder healthy female (elder healthy female group) and 24 elder healthy male (elder healthy male group) were selected.The gender differences and correlation of anal rectal function and psychological factors were compared in elderly patients and control group,by using anorectal manometry and psychological testing methods.Results Compared with elder healthy female group,maximum squeeze pressure (MSP),anorectal pressure decreased in elder healthy male group(P ＜ 0.05 or ＜ 0.01),anal canal overpressure,first sensation volume(FSV),defecating sensation volume(DSV),maximum tolerable volume(MTV) increased in elder female patients group (P＜ 0.01).Compared with elder male healthy group,anal canal excess pressure increased,anorectal pressure decreased (P＜ 0.05),and FSV,DSV,MTV increased in elder male patients group (P ＜ 0.01 or ＜ 0.05).MSP,rectum systolic pressure,anorectal pressure in elder female patients group was lower than that in elder male patients group (P ＜ 0.05 or ＜ 0.01),rectal tube excess pressure and rectal sensation threshold was higher than that in elder male patients group,but there was no significant difference (P ＞ 0.05).RRP,rectum systolic pressure,anorectal pressure in elder female healthy group was lower than that in elder male healthy group (P ＜ 0.01).FSV was higher than that in elder male healthy group (P ＜ 0.01).SAS score and SDS score was higher in elder female patients group was higher than that in elder female healthy group (P＜ 0.01),SAS score and SDS score was higher in elder male patients group was higher than that in elder male healthy group(P＜ 0.05 or ＜ 0.01).SAS score was negatively correlated with MSP,rectum systolic pressure,anorectal pressure(P ＜ 0.01),was positively correlated with FSV(P ＜ 0.05).SDS score was negatively correlated with anorectal pressure (P ＜ 0.01),was positively correlated with FSV,DSV,MTV (P ＜0.01).Conclusions Anorectal dys function and psychological factors are involved in the elderly FC pathogenesy,and the two are related.Elderly female patients exist more severe anxiety and anorectal motility disorders than male patients.

Objective To investigate the effects of high-fat diet on pancreatic acinar cells' IP3 expression and CCK-induced amylase release in rats.Methods Male Wistar rats were divided into high-fat diet group and normal diet group,they were fed for 4 weeks.Blood triglycerides,cholesterol,amylase and glucose levels were determined by automatic biochemical analyzer.Pancreatic tissues were taken for histopathological observations.Pancreatic acinar cells were isolated and cultured,and intracellular inositol 1,4,5-trisphosphate (IP3) was detected using a commercial kit.Amylase release rates were measured after CCK-8 stimulation.Results The rats in high-fat diet group appeared hyperlipidemia,vacuolization of acinar cells and the lymphocytes appeared around the acinar cells can be seen on the pancreatic tissue pathology staining.The levels of IP3 in acinar cells of rats fed a high-fat diet were higher than that of normal rats [(31.807 ± 3.448) pmol/106 cells vs (24.632 ± 3.649) pmol/106 cells,t=7.479,P＜0.001];and amylase release rate in these rats'acinar cells were also higher than those of normal rats [when CCK-8=0.01 nmol/L:( 11.056 ±3.369)％ vs (7.354 ± 2.181) ％,t=3.912,P＜0.001;when CCK-8=1 nmol/L:( 13.854 ± 4.087 ) ％ vs (9.432 ±2.477) ％,t=3.939,P＜0.001 ) after CCK-8 stimulation in different concentrations.Additionally,there was a positive co-relationship between acinar cell's IP3 level and amylase release (r=0.896,P＜0.001 ).Conclusion Chronic high-fat diet induces hypersensitivity for pancreatic acinar cells' exocrine function,and IP3 as a signal molecule may play an important role in this process.

The instrument is com posed of such components as SCM,pressure sensor,electric pump,magnetic valve and sleeve-type gasbag.It can control the hemostatic pressure,hemostatic time and slack time automatically.So the ischemic necrosis can be avoided thoroughly thr ough it.With the small volume,light weight,low power consumption and convenient operation,the instrument is fit for emergency treatment of mass casualties.

Objective To study the pathogenesis of osteoporosis in patients with liver cirrhosis following hepatitis B virus(HBV) infection(HBV-liver cirrhosis).Methods Bone mineral density(BMD) was measured by NM-300 sigle-energy X-ray acsorptiometry system for 61 patients with HBV-liver cirrhosis and 30 age-matched healthy controls.Serum levels of calcium regulatory hormones(CRH),1,25-dihydroxycholecalciferol [1,25(OH)_2D_3],parathyroid hormone(PTH),calcitonin(CT),osteocalcin(BGP),interleukin-1?(IL-1?),interleukin-6(IL-6) and tumor-necrosis factor-?(TNF-?),and urine level of crosslaps were measured in these patients and controls.Patients with HBV-liver cirrhosis were divided into two groups,osteoporotic and non-osteoporotic,based on their BMD in the ulna and radius,for comparison.Results BMD of the ulna and radius in patients with HBV-liver cirrhosis were significantly lower than those in controls.Serum levels of 1,25(OH)_2D_3 and BGP in patients with HBV-liver cirrhosis were significantly lower than those in controls,and much lower in osteoporotic group than that in non-osteoporotic one.While urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls, much more increased in the those with osteoporosis than those without osteoporosis.Serum level of 1,25(OH)_2D_3 correlated with serum levels of BGP and BMD of the ulna and radius.Urine level of crosslaps correlated inversely with BMD of the ulan and radius in osteoporotic patients,but not in non-osteoporotic ones.Serum levels of IL-1?,IL-6 and(TNF-?) and urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls,as well as increased significantly in those with osteoporosis than in those without osteoporosis.Serum levels of IL-1?,IL-6 and TNF-? and urine level of crosslaps correlated inversely with BMD of the ulna,particularly more significantly in those with osteoporosis than those without osteoporosis.Conclusions Two factors,less osteogenesis and more osteolysis,existed in patients with HBV-liver cirrhosis.Serum level of 1,25(OH)_2D_3 and serum levels of IL-1?,IL-6 and(TNF-?) played an important role in weakened bone formation and in increased bone resorption,respectively.Adequate supplementation of vitamin D_3 and reducing serum levels of IL-1?,IL-6 and TNF-? may be very important for prevention and treatment of hepatic bone disease.

Objective To prove the clinical effect of portable auto-haemostat machine on body's limbs. Methods Portable auto-haemostat machine was applied to the indicated patients in their clinical aid treatments course, i.e. the rapid hemostasis on limbs. Results The hemostasis was rapid and accurate with hemostatic pressure in the range from 190 to 230 mmHg. The excellent effect guarantees the diagnosis, observation, bandaging and secure transmission of victims until they were sent to the operation room. Conclusion It is reliable to use portable auto-haemostat machine on body's limbs in clinic works.