In recent years, the individualized comprehensive treatment mode led by mini-mally invasive techniques in the early stage of acute pancreatitis (AP) has significantly reduced its mortality rate. However, the overall complication rate remains high. This predicament has been prompting us to continuously explore and improve the early diagnosis and treatment strategies for AP. Changes in the functional and morphological aspects of the gallbladder are no longer confined to biliary pancreatitis alone. Cholestasis, gallbladder enlargement, increased tension, and significant alterations in the composition of bile are commonly observed in patients with AP caused by various factors, and these changes are closely related to the prognosis of the patients. Against this backdrop, the authors propose the new concept of bile diversion treatment, that is, percutaneous transhepatic gallbladder drainage guided by ultrasound combined with bile reinfusion. In practice, it has been observed that the application of bile diversion can effectively improve the short-term efficacy of AP patients with gallbladder enlargement and accelerate their recovery. The authors elaborate on the role and value of bile diversion in the treatment of AP. It is believed that with the continuous in-depth development of basic research and the continuous optimization of clinical practice pathways and protocols, bile diversion is expected to become an important part of the comprehensive treatment of AP, thus bringing more survival benefits to AP patients.

In recent years, the individualized comprehensive treatment mode led by mini-mally invasive techniques in the early stage of acute pancreatitis (AP) has significantly reduced its mortality rate. However, the overall complication rate remains high. This predicament has been prompting us to continuously explore and improve the early diagnosis and treatment strategies for AP. Changes in the functional and morphological aspects of the gallbladder are no longer confined to biliary pancreatitis alone. Cholestasis, gallbladder enlargement, increased tension, and significant alterations in the composition of bile are commonly observed in patients with AP caused by various factors, and these changes are closely related to the prognosis of the patients. Against this backdrop, the authors propose the new concept of bile diversion treatment, that is, percutaneous transhepatic gallbladder drainage guided by ultrasound combined with bile reinfusion. In practice, it has been observed that the application of bile diversion can effectively improve the short-term efficacy of AP patients with gallbladder enlargement and accelerate their recovery. The authors elaborate on the role and value of bile diversion in the treatment of AP. It is believed that with the continuous in-depth development of basic research and the continuous optimization of clinical practice pathways and protocols, bile diversion is expected to become an important part of the comprehensive treatment of AP, thus bringing more survival benefits to AP patients.

Objective To understand the dilemma and coping experience of pediatric nurses participating in medication safety management,so as to provide a reference for improving the quality of medication safety management.Methods This study was a descriptive phenomenological study.The puiposive sampling method was used to conduct semi-structured interviews with 21 pediatric nurses from in a tertiary A hospital in Nanjing from January to February 2024.The interview data were extracted,coded,cluster screened,interpreted and verified by the Colaizzi seven-step analysis method.Results In terms of the dilemmas of pediatric nurses involved in medication safety management,there were 3 themes,including knowledge and skills,environment and resources,understanding and cooperation,and 7 sub-themes.In terms of coping experience of pediatric nurses involved in medication safety management dilemma,there were 3 themes,including responsibility and emotion,communication and collaboration,system and supervision,and 4 sub-themes.Conclusion Pediatric nurses will encounter various difficulties and actively adopt various coping strategies when participating in medication safety management.It is recommended that nursing managers strengthen education and training,quality management,continuously improve nurses'safety responsibility awareness and empathy ability,encourage parents of children to participate in medication safety management,and actively improve the pediatric working environment,continuously strengthen organizational support,and promote communication and collaboration to ensure medication safety.

Objective To construct a theoretical model of venous thromboembolism(VTE)risk perception in pregnant women,so as to provide a scientific basis for promoting pregnant women to form a correct risk perception of VTE and actively take preventive behaviors.Methods A qualitative research approach guided by the procedural grounded theoiy was adopted.Data were collected by a semi-structured deep interview on 18 pregnant women who received prenatal examination in the outpatient department of a tertiary A obstetrics and gynecology hospital in Nanjing from June to July 2023,and the data were analyzed by three-level coding and continuous comparison method.Results The VTE risk perception of pregnant women was affected by 6 factors including social coupling system,self health status,life behavior habits,knowledge on disease,compliance behavior and emotional stimulation.Pregnant women perceived VTE risk from 3 aspects:threats to maternal and child safety,increased family economic burden and increased time cost,impact on social roles.Thus,3 health behavior decisions were formed,including taking preventive behaviors,overcoming implementation barriers,and seeking knowledge behaviors,in order to reduce their own risk of VTE,and prevent the occurrence of VTE.Conclusion The theoretical model of VTE risk perception of pregnant women can guide medical staff to comprehensively consider the influencing factors of VTE risk perception of pregnant women,optimize the form and content of VTE health education,give pregnant women individualized and sustainable VTE prevention guidance,and strengthen pregnant women's perception of VTE risk and the benefits of preventive behavior,so as to actively take the correct health behavior decisions.

Objective To explore the dyad coping experience of stress in pregnant women with undifferentiated connective tissue disease and their spouses,providing a basis for developing dyadic coping intervention measures.Methods By purposive sampling,15 pairs of pregnant women and their spouses who visited the outpatient clinic for pregnancy complicated with immune diseases in a matemity hospital in Jiangsu Province from April to August 2023 were selected as the research subjects for semi-structured interviews.Content analysis was conducted using the Colaizzi 7-step method,and an interview outline and integrated themes were developed based on the Developmental Contextual Coping Model.Results 3 themes(coexistence of positive and negative stress experiences;diverse approaches to dyadic coping with stress;growth and challenges following stress adaptation)and 11 subthemes were identified.Conclusion Healthcare professionals should attach importance to the stress coping issues of pregnant women with undifferentiated connective tissue disease and their spouses,take measures to regulate the negative emotions of couples,ensure multi-faceted support,help the couple adopt positive coping strategies,and promote good stress adaptation.

Objective To understand the dilemma and coping experience of pediatric nurses participating in medication safety management,so as to provide a reference for improving the quality of medication safety management.Methods This study was a descriptive phenomenological study.The puiposive sampling method was used to conduct semi-structured interviews with 21 pediatric nurses from in a tertiary A hospital in Nanjing from January to February 2024.The interview data were extracted,coded,cluster screened,interpreted and verified by the Colaizzi seven-step analysis method.Results In terms of the dilemmas of pediatric nurses involved in medication safety management,there were 3 themes,including knowledge and skills,environment and resources,understanding and cooperation,and 7 sub-themes.In terms of coping experience of pediatric nurses involved in medication safety management dilemma,there were 3 themes,including responsibility and emotion,communication and collaboration,system and supervision,and 4 sub-themes.Conclusion Pediatric nurses will encounter various difficulties and actively adopt various coping strategies when participating in medication safety management.It is recommended that nursing managers strengthen education and training,quality management,continuously improve nurses'safety responsibility awareness and empathy ability,encourage parents of children to participate in medication safety management,and actively improve the pediatric working environment,continuously strengthen organizational support,and promote communication and collaboration to ensure medication safety.

Objective To establish a postpartum depression animal model induced by pre-pregnancy stress,assess abnormal maternal depressive-like behavior,observe the expression of disrupted-in-schizophrenia 1 (DISC1) in the hippocampus,and detect serum estradiol and corticosterone.Methods A total of 32 female Balb/c were assigned to two groups using random number table:the control group and the pre-pregnancy stressed group(model group),and the model group was subjected to 3 weeks of chronic restraint stress. After the last stressor,the control group and the model group were housed with a male. About 4 weeks later,the mice gave birth to pups. Then at 3 weeks postpartum,open field test,tail suspension test,and sucrose preference test were carried out. The expressions of DISC1 mRNA and protein of hippocampus were detected by real-time quantitative polymerase chain reaction and Western blot,respectively. The serum levels of estradiol and corticosterone were detected with enzyme linked immunosorbent assay. Results After 3 weeks of postpartum,the model mice showed depression-like behaviors. In the open field test,there was no effect on the total distance moved or time spent in the center field (P>0.05). Immobility in tail suspension test was significantly increased (t=-4.950,P<0.001) and sucrose preference was significantly reduced in model group (t=2.475,P<0.05). There was significant statistical difference between control and model group on the expression of DISC1 mRNA (t=-8.915,P<0.001) and protein (t=-5.004,P<0.01) in hippocampus. There was no significant statistical difference on estradiol and corticosterone between two groups (P>0.05). Conclusion Chronic pre-pregnancy stress can induce dams into postpartum depression.The pathogenesis of postpartum depression may be related to the regulation of DISC1 in the hippocampus.

Major depression is a public health problem that seriously harms individuals and the society.But one of the major shortcomings of mainstream antidepressant is the delayed onset.Recent series of studies demonstrated that,from a variety of animal models and clinical studies,classic stagnation-removing formula Yue-Ju (Y J) pill has the advantage in rapid antidepressant efficacy,which is similar to the prototype drug ketamine.It has the mechanism of rapid and sustained enhancement of neural plasticity and individual difference in response to YJ pill.The evidence of Gardenia jasminoides (Zhi-Zi) as the monarch component of YJ pill's rapid antidepressant action has also been revealed.The further in-depth research on rapid antidepressant traditional Chinese medicine (TCM) is important for providing the scientific and reliable TCM strategies to treat depression.

Aim To study the preventive and therapeutic effects of Buyang Huanwu Decoction(BYHWD)on denervated tibial muscle atrophy of rats.Methods After 60 Sprague-Dawley rats were subjected to Common Peroneal nerve crush model of 5 mm injury, they were randomly divided into 6 groups for daily intragastric administration of drugs:BYHWD high-dose, medium-dose, low-dose groups, mecobalamin group(positive control), model group, sham operation group.The drug administration lasted for 18 days.18 days after operation, slice, masson staining and analysis morphology were performed. The wet weight ratio and section area of tibial muscle were also measured.Results Tibial muscle section area of sham operation group was large, morphous was regular, while that of model group significantly diminished, structure was chaotic, and connective tissue hyperplasia was more obvious;Tibial muscle section area of BYHWD group and mecobalamin group was fairly diminished, morphous was fairly regular, and connective tissue hyperplasia was not obvious.Compared with model group, the section area of BYHWD group all increased significantly(P <0.01)in a dose-dependent manner.Compared with mecobalamin group, the cross section area of BYHWD high-dose group was significantly larger(P <0.05).Compared with model group, the wet weight ratio of BYHWD high-dose and medium-dose group all increased significantly(P <0.01 or P <0.05)in a dose-dependent manner.Conclusion BYHWD has a significant effect of prevention and therapy on denervated tibial muscle atrophy of rats.

Objective To observe the effects of total saponins of tribulus of various consistency on the differentiation of neural hippocampus stem cells. Methods The hippocampus stem cells from newborn rat were obtained by serum-free medium and single-cell cloning technique. Hippocampus stem cells were induced by total saponins of tribulus of various consistency. Nestin, BrdU, neurofilament (NF-200), glial fibrillary acidic protein (GFAP) expression were detected using immunocytochemical stains. The numbers of NF and GFAP positive cells were counted. The percentages of positive cells were obtained. Results The dissociated cells from the organ of hippocampus developed into much of indiffrentiated otopheres of nestin positive cells. The hippocampus stem cell differentiated into neurons and astrocytes with the total saponins of tribulus. The percentage of NF positive neuron in the 20 mg/kg consistency of total saponins of tribulus groups was significantly higher than that in the control group and other consistency of total saponins of tribulus groups. Conclusion Total saponins of tribulus may enhance neural hippocampus stem cells differentiate into NF positive neuron.