Objective:To investigate the correlation between gallbladder polyps and colon polyps of different locations.Methods:Healthy subjects who underwent colonoscopy in the Physical Examination Center of the Affiliated Hospital of Yangzhou University from January 2020 to October 2022 were included. They were divided into the proximal colon group and the distal colon group according to the location of colon polyps. Gallbladder polyps were compared with other known risk factors for colon cancer. Different parts and types of polyps were further explored.Results:A total of 2 811 patients had colon polyps, including 1 668 males and 1 143 females, with an average age of 47.3 years. One hundred and seventy-one (6.1%) had gallstones, and 459 (16.3%) had gallbladder polyps. The incidence of gallbladder polyps was higher in the proximal colon polyp group (21.7%, 93/429). Gallbladder polyps were independently associated with proximal colon polyps, including hyperplastic polyps ( OR=1.525, P=0.029) and adenomatous polyps ( OR=1.425, P=0.017). There was no significant correlation between gallbladder polyps and distal colon polyps. Conclusion:Gallbladder polyps are associated with proximal colon polyps, and colonoscopy screening is recommended for people with gallbladder polyps.

Objective:To explore the clinical value of cluster management in secondary hydrocephalus.Methods:Seventy-seven patients with secondary hydrocephalus admitted to Department of Neurosurgery, Shenzhen Second People's Hospital from January 2016 to June 2021 were chosen; they were divided into traditional management group ( n=30) and cluster management group ( n=47) according to different management methods. Patients in traditional management group accepted craniocerebral CT and 3 consecutive times of cerebrospinal fluid tests, and normal results were achieved and then ventriculoperitoneal shunt (VPS) was performed. In patients from the cluster management group, on the basis of management treatment, cranial plain and enhanced MRI and DNA metagenomic next generation sequencing of cerebrospinal fluid were performed before surgery, and rapid test of cerebrospinal fluid and ventriculoscope observation were performed during surgery; after exclusion of intracranial infection, VPS was performed. The differences of shunt failure rate were compared between the two groups and the positive rates of intracranial infection detected by above 4 methods were compared in the cluster management group. Results:There was significant difference in shunt failure rate between the cluster management group and traditional management group (2.1% vs. 20.0%, P<0.05). The positive rates of intracranial infection by DNA metagenomics (61.7%) and ventriculoscopy (68.1%) were significantly higher than those by preoperative cranial plain and enhanced MRI (14.9%) and rapid test of cerebrospinal fluid (6.4%, P<0.05). Conclusion:Cluster management can effectively decrease the VPS failure rate in secondary hydrocephalus; DNA metagenomics and ventriculoscopy have high efficiency in detecting intracranial infection.

Objective:To explore the effect of the combination of hyperbaric oxygen（HBO）and gemcitabine（GEM）on the apoptosis of PANC-1 cells and tumor markers in the serum of nude mice with pancreatic cancer.Methods:Fifteen nude mouse models of transplanted tumors of pancreatic cancer were established and randomly divided into control group，GEM group，and HBO+GEM group according to the experimental design，with five mice in each group. The control group was reared normally after successful modeling. The GEM group was treated with 10 mg/kg of GEM by gavage，and the HBO+GEM group was treated with 10 mg/kg of GEM by gavage followed by oxygen inhalation at 0.2 MPa for 60 min. All the three groups were treated every other day for 21 days. The volume and weight of transplanted tumors were measured，the apoptosis of PANC-1 cells was detected by TUNEL staining，and the levels of serum tumor markers were measured using an automated chemiluminescence immunoassay analyzer. The expression levels of apoptosis-related proteins in tumor tissues were measured by western blotting.Results:The tumor volume of the nude mice in the HBO+GEM group was significantly lower than those of the control group and the GEM group on the 6th，9th，10th，15th，18th，and 21st days，with statistically significant differences（ P<0.05）. The tumor weight［（0.54±0.08）g］in the HBO+GEM group was significantly lower than those in the control group［（1.23±0.17）g］and the GEM group［（0.89±0.11）g］，and the differences were statistically significant（ P<0.05）. The apoptosis rate of PANC-1 cells in the HBO+GEM group［（47.26±7.22）%］was significantly higher than those in the control group［（6.83±0.89）%］and the GEM group［（26.84±3.29）%］，and the differences were statistically significant（ P<0.05 or P<0.01）. Compared with the control group and the GEM group，the serum levels of carcinoembryonic antigen（CEA）of the nude mice in the HBO+GEM group were significantly reduced，while the levels of carbohydrate antigen 19-9（CA19-9）and tumor-specific growth factors（TSGF）in the HBO+GEM group were significantly increased，and the differences were statistically significant（ P<0.05）. Compared with the control group and the GEM group，the expression levels of Bax，Caspase-3，and Cytochrome C protein in the transplanted tumor tissues of the nude mice in the HBO+GEM group were significantly higher，while the expression level of Bcl-2 protein was significantly lower，all with statistically significant differences（ P<0.05）. Conclusion:The combination of HBO+GEM can enhance the inhibitory effect of GEM on transplanted tumors of pancreatic cancer in nude mice，and its mechanism may be related to inducing the apoptosis of PANC-1 cells and regulating CEA，CA19-9，and TSGF.

Objective:To explore the effect of the combination of hyperbaric oxygen（HBO）and gemcitabine（GEM）on the apoptosis of PANC-1 cells and tumor markers in the serum of nude mice with pancreatic cancer.Methods:Fifteen nude mouse models of transplanted tumors of pancreatic cancer were established and randomly divided into control group，GEM group，and HBO+GEM group according to the experimental design，with five mice in each group. The control group was reared normally after successful modeling. The GEM group was treated with 10 mg/kg of GEM by gavage，and the HBO+GEM group was treated with 10 mg/kg of GEM by gavage followed by oxygen inhalation at 0.2 MPa for 60 min. All the three groups were treated every other day for 21 days. The volume and weight of transplanted tumors were measured，the apoptosis of PANC-1 cells was detected by TUNEL staining，and the levels of serum tumor markers were measured using an automated chemiluminescence immunoassay analyzer. The expression levels of apoptosis-related proteins in tumor tissues were measured by western blotting.Results:The tumor volume of the nude mice in the HBO+GEM group was significantly lower than those of the control group and the GEM group on the 6th，9th，10th，15th，18th，and 21st days，with statistically significant differences（ P<0.05）. The tumor weight［（0.54±0.08）g］in the HBO+GEM group was significantly lower than those in the control group［（1.23±0.17）g］and the GEM group［（0.89±0.11）g］，and the differences were statistically significant（ P<0.05）. The apoptosis rate of PANC-1 cells in the HBO+GEM group［（47.26±7.22）%］was significantly higher than those in the control group［（6.83±0.89）%］and the GEM group［（26.84±3.29）%］，and the differences were statistically significant（ P<0.05 or P<0.01）. Compared with the control group and the GEM group，the serum levels of carcinoembryonic antigen（CEA）of the nude mice in the HBO+GEM group were significantly reduced，while the levels of carbohydrate antigen 19-9（CA19-9）and tumor-specific growth factors（TSGF）in the HBO+GEM group were significantly increased，and the differences were statistically significant（ P<0.05）. Compared with the control group and the GEM group，the expression levels of Bax，Caspase-3，and Cytochrome C protein in the transplanted tumor tissues of the nude mice in the HBO+GEM group were significantly higher，while the expression level of Bcl-2 protein was significantly lower，all with statistically significant differences（ P<0.05）. Conclusion:The combination of HBO+GEM can enhance the inhibitory effect of GEM on transplanted tumors of pancreatic cancer in nude mice，and its mechanism may be related to inducing the apoptosis of PANC-1 cells and regulating CEA，CA19-9，and TSGF.

OBJECTIVE：To investigate the contents of 5 kinds of heavy metal as copper （Cu），arsenic（As），cadmium （Cd），mercury（Hg）and lead （Pb）in Yougui pills ，and to evaluate its safety risk. METHODS ：Using yttrium （89Y），indium （115In）and bismuth （209bi）as internal standard ，the contents of each element were determined by ICP-MS. ICP-MS condition included that atomization gas flow rate was 0.95 L/min，auxiliary gas flow rate was 1.2 L/min，plasma gas （argon）flow rate was 18 L/min，pump speed was 30 r/min. RF power of inductively coupled plasma was 1 200 W，the voltage in simulation stage was 1 750 V，the voltage in pulse stage was 1 300 V，the voltage of deflection device was －12 V，and the detector was in analog and pulse dual-mode. The determination methods of various elements were investigated ，and 45 batches of marketed Yougui pills were determined. Hazard index （HI）was used to analyze the non-carcinogenic risk of each element and calculate the maximum residual limit（MRL）of each element. RESULTS ：The linear range of Cu ，As，Cd，Hg and Pb ranged from 10-200，1-50，0.4-30，0.2-6 and 2-100 μg/L（all r＞0.999 0），respectively. The limits of quantitation were 0.67，0.23，0.20，0.07，0.27 μg/L. The limits of detection were 0.20，0.07，0.06，0.02，0.08 μg/L. RSDs of precision，stability and reproducibility tests were all lower than 3.5％ （n＝6 or n＝5）. Average recoveries were 92.96％-100.89％（RSD＝2.23％-3.62％，n＝3）. Average contents of Cu ，As，Cd，Hg and Pb in 45 batches of Yougui pills were 2.72，0.28，0.07，0.05，0.62 mg/kg，and superimposed HI of each element was less than 1. The contents of 5 kinds of heavy metals in Yougui pills were lower than the proposed MRL （MRL of Cu ，As，Cd，Hg and Pb were 20，2，1，0.2，5 mg/kg or 111.11，4.44，2.22，1.48，8.89 mg/kg respectively ）. CONCLUSIONS ：Established method can be used for the determination of content of 5 kinds of heavy metal in Yougui pills ；the heavy metal pollution rate of marketed Yougui pills is low and the safety risk is small.

Objective:To discuss the effect of optimized catheter management strategy on reducing the incidence of catheter-related adverse events in interhospital patients transition with extracorporeal membrane oxygenation (ECMO).Methods:A historical control trial was conducted. The patients transferred with ECMO to the Second Affiliated Hospital of Nanchang University from January 2018 to December 2020 were enrolled. From January 2019 to December 2020, 38 patients with interhospital transport using optimized catheter management strategy were as observation group; from January to December in 2018, 30 patients with routine catheter management method were selected as the control group. The incidence of catheter-related adverse events during transition was compared between the two groups.Results:There were no significant differences in clinical data such as age, number of catheters, transit time, transit distance, ECMO operation time between the observation group and the control group [age (years old): 58.26±10.38 vs. 54.00±16.61, number of catheters (roots): 6.03±1.32 vs. 5.51±1.37, transit time (hours): 2.48±0.30 vs. 2.51±0.39, transfer distance (kilometers): 155.27±20.45 vs. 165.56±25.62, ECMO operating time (days): 8.47±1.28 vs. 9.11±1.99, all P > 0.05]. The incidence of catheter-related adverse events in the control group was 26.67% (8/30), among them, 2 patients had ECMO catheter discount after getting over the bed, causing the flow alarm; 1 patient's central venous catheter (CVC) was not placed with U-shape and twisted, the vasopressors were not entered in time, which caused hypotension; 3 patients had more bleeding at the puncture points and film crimping; the urinary catheters were clamped in 2 patients and not opened in time. In the observation group, the patients did not have catheter-related adverse events during transition. There was statistically significant difference in the incidence of catheter-related adverse events between the two groups (χ 2 = 7.814, P < 0.05). Conclusion:The implementation of optimized catheter management strategy can greatly reduce the incidence of catheter-related adverse events and provide an effective safety guarantee for the interhospital transit of ECMO patients.

Objective:To evaluate the microstructural changes of brain parenchyma in patients with essential hypertension by diffuse kurtosis imaging (DKI) and enhanced T2 star weighted angiography (ESWAN).Methods:A prospective study was performed; 27 patients with essential hypertension, admitted to our hospital from April 2019 to September 2019, and 16 healthy subjects matched with gender, age and education level were enrolled in our study. According to the presence or absence of cerebral microbleeds (CMBs), patients with essential hypertension were divided into essential hypertension with CMBs group ( n=8) and essential hypertension without CMBs group ( n=19). MRI, DKI and ESWAN were performed on all subjects. The mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) of bilateral hippocampal gyrus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus, red nucleus, substantia nigra, pons, and cerebellum were measured. Results:As compared with the healthy subjects, the patients with essential hypertension had significantly lower MK values in the left semioval center, bilateral caudate head, left posterior limb of internal capsule, and bilateral thalamus, significantly higher MD value in the right thalamus, and statistically lower FA value in the left posterior limb of internal capsule ( P<0.05). The essential hypertension with CMBs group had significantly lower MK values in left hippocampus gyrus, left centrum semiovale, bilateral caudate head, left posterior limb of internal capsule, bilateral thalamus, and left substantia nigra, significantly higher MD value in right thalamus, and significantly lower FA value in left posterior limb of internal capsule as compared with essential hypertension without CMBs group and healthy control group ( P<0.05). Conclusion:In patients with essential hypertension, the brain microstructural changes are found in the hippocampus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus and substantia nigra; these changes are more obvious in essential hypertension patients with CMBs; DKI and ESWAN can effectively assess the early brain microstructure changes in patients with essential hypertension.

Objective To investigate the risk factors for post-traumatic hydrocephalus ( PTH) after traumatic brain injury ( TBI ) . Methods A retrospective case control analysis was made on the clinical data of 794 patients with acute TBI admitted to Shenzhen Second People's Hospital between January 2007 and January 2017. There were 639 males and 155 females, aged 1-90 years [(40. 5 ± 18. 6)years]. All patients were followed up for 1 years, and the patients were divided into PTH group (n=46) and non-PTH group (n=748) according to their prognosis. The following information including Glasgow coma score ( GCS ) on admission, pupil reflex, midline shift and cistern compression, subarachnoid hemorrhage ( SAH ) , operation method, decompressive craniectomy, hydrocephalus after operation, intracranial infection, timing of cranioplasty were analyzed using univariate analysis and Logistic regression. Results PTH occurred in 46 patients (5. 8％). Univariate analysis showed that GCS, midline shift, decompressive craniectomy, subdural effusion, timing of cranioplasty and SAH were significantly related to PTH (P<0. 05 or 0. 01). Logistic regression identified low GCS (OR=3. 778), decompressive craniectomy (OR=2. 508), subdural effusion (OR=2. 269), timing of cranioplasty (≥3 months)(OR=10. 478) and SAH (OR=23. 391) as the independent risk factors for PTH (P<0. 05 or 0. 01). Conclusion PTH is a common serious complication of traumatic brain injury, affected by low GCS, decompressive craniectomy, subdural effusion, delayed cranioplasty and SAH.

The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was used for appraisal in a newly-built general hospital for all the nursing staff, and they were provided with a six-month safety culture training according to appraisal results.The training has elevated the positive response rate of the nursing staff towards all dimensions of patient safety culture, proving that scientific and reasonable safety culture training is conducive to nurses' perception of patient safety culture.