This article summarizes the rapid rehabilitation nursing experience for one pediatric pa-tient with pancreatic divisum who underwent en bloc pancreatoduodenectomy preserving the duodenum,common bile duct,and Oddi's sphincter(DCOPPHTR).The nursing care encompassed preoperative prehabilitation to enhance physical and psychological preparation,postoperative precise volume and dynamic blood glucose management,early mobilization to facilitate recovery,personalized nutritional support to improve nutritional status,psychological nursing to bolster confidence,and family involve-ment to enhance quality of life.The pediatric patient experienced rapid recovery and was discharged from the hospital.A six-month follow-up indicated a significant improvement in quality of life.

Purpose To investigate the clinical value of artificial intelligence(AI)quantitative parameters in predicting the invasion degree of lung adenocarcinoma with diameter≤2 cm of ground-glass density.Materials and Methods A total of 80 patients with lung adenocarcinoma with diameter≤2 cm ground-glass density confirmed by pathology from March 2019 to April 2022 were retrospectively analyzed.A total of 90 nodules were rerolled,including 8 adenocarcinomas in situ(AIS),34 minimally invasive adenocarcinomas(MIA)and 48 invasive adenocarcinomas(IAC).They were divided into the experimental group(IAC)and the control group(AIS and MIA).The differences of the AI quantitative parameters such as volume,three-dimensional length diameter,maximum area,maximum CT value,minimum CT value and average CT value were compared between two groups,and the predictive values of AI quantitative parameters for the invasion degree of lung adenocarcinoma was evaluated.Results There were statistically significant differences with age,volume,three-dimensional length diameter,maximum area,maximum CT value and average CT value between the two groups(all P<0.05),but no statistically significant differences in gender and minimum CT value(both P>0.05).Binary Logistic regression analysis showed that the three-dimensional length diameter(odd ratio=2.020,P=0.034)and the maximum CT value(odd ratio=1.008,P=0.013)were independent predictors for lung adenocarcinoma with diameter≤2 cm of ground-glass density.The regression model based on the three-dimensional length diameter and the maximum CT value had the best predictive performance,and its AUC was 0.901.When the critical value was 2.432,its sensitivity and specificity were 93.75%and 71.43%,respectively.Conclusion AI quantitative parameters have a high value in predicting the degree of invasion of lung adenocarcinoma with diameter≤2 cm of ground-glass density,and the combined model with three dimensional long diameter and maximum CT value has the highest diagnostic efficiency.

Objective:To explore the optimal acceleration factor and feasibility of the compressed SENSE (CS) technique in non-contrast MR coronary angiography (NMRCA) for clinical practice.Methods:The image data of completed coronary CTA and 3.0 T NMRCA sequence in 31 patients with suspected coronary heart disease were prospectively recruited at Fuyang People′s Hospital from August 2021 to November 2021. NMRCA sequences included conventional SENSE2 sequence and CS sequences with acceleration factors of 4, 5, and 6, respectively. The subjective scores of image quality and the objective scores, the contrast ratios between assessed coronaries and myocardium (CMCR) were compared among the 4 groups using the Friedman and Wilcoxon rank sum test.Results:Compared with the conventional SENSE2 [(343±46)s], the scan time of CS4 (269±36), CS5 (214±29) and CS6 (178±26) s were shortened by 21.5%, 37.5% and 48.0%, respectively. There was a good consistency between the subjective scores of the four groups (Kappa=0.769, 95% Cl 0.738-0.800). There was no significant difference in subjective score and CMCR value between CS4 and SENSE2 ( P>0.05). The coronary artery segments of CS5 and CS6 were significantly different from SENSE2 group ( P<0.05). Conclusions:For 3.0 T NMRCA, CS technology shows high feasibility. The CS4 can reduce imaging time while ensuring high-quality coronary arterial images, which has a well-established clinical application value for NMRCA.

Objective: To investigate the effect of intensive insulin therapy on the immune function and prognosis of severe thoracic injuries patients with stress hyperglycemia. Methods: A retrospective case control study was performed to analyze the clinical data of 60 patients with severe chest trauma and stress-induced hyperglycemia admitted to Chongqing People's Hospital from October 2016 to October 2018. There were 31 males and 26 females, aged 25-61 years [(46.1±4.0)years]. The abbreviated injury scale (AIS) range was 3-5 points. Thirty patients received routine insulin therapy (routine treatment group) and thirty patients received intensive insulin therapy (intensive treatment group). Venous blood was collected from two groups of patients before treatment, 1 day, 3 days, 5 days and 7 days after treatment respectively. Level of inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP)], and lymphocyte count (CD₁₄^＋, CD₄^＋ and CD₄^＋/CD₈^＋) were detected respectively. The incidence of nosocomial infection, length of hospital stay, mortality and incidence of hypoglycemia were compared between the two groups. Results: There were no significant differences in plasma TNF-α, IL-6 and CRP levels between the two groups before treatment (P>0.05). After treatment (1-7 days), the levels of serum TNF-α, IL-6 and CRP in the intensive treatment group were lower than those of routine treatment group (P<0.05 or 0.01). Compared with these before treatment, the levels of TNF-α, IL-6 and CRP in both groups increased to varied degrees, reaching a peak on day 3, followed by a gradual decline (P<0.05 or 0.01). There were no statistically significant differences in CD₁₄^＋, CD₄^＋、CD₄^＋/CD₈^＋ lymphocyte counts between the two groups before treatment (P>0.05). On days 3, 5, and 7 after treatment, the counts of CD₁₄^＋ lymphocytes [3 d: (0.61±0.08)×10⁹ vs. (0.55±0.09)×10^9, 5 d: (0.68±0.05)×10⁹ vs. (0.63±0.05)×10^9, 7 d: (0.77±0.07)×10⁹ vs. (0.71±0.06)×10⁹], CD₄^＋ lymphocytes [3 d: (0.29±0.04)×10⁹ vs. (0.25±0.03)×10^9, 5 d: (0.32±0.04)×10⁹ vs. (0.30±0.05)×10^9, 7 d: (0.34±0.03)×10⁹ vs. (0.32±0.06)×10⁹], CD₄^＋/CD₈^＋ lymphocytes [3 d: (0.28±0.04)×10⁹ vs. (0.26±0.06)×10^9, 5 d: (0.33±0.03)×10⁹ vs. (0.31±0.06)×10^9, 7 d: (0.35±0.03)×10⁹ vs. (0.32±0.06)×10⁹] in the intensive treatment group were higher than those in the routine treatment group. Compared with before treatment, the counts of CD14⁺ , CD4⁺ , CD4⁺ /CD8⁺ lymphocytes in the two groups were raised to different degrees after treatment for 3 days, with significant differences (P<0.05 or 0.01). Compared with routine treatment group, patients in intensive treatment group had lower incidence of nosocomial infection [57%(17/30) vs. 30%(9/30)], shorter duration of mechanical ventilation [(12.8±2.4)vs. (7.4±1.2)days], and lower hospital mortality rate [27%(8/30) vs. 10%(3/30)]. There was no significant difference in the incidence of hypoglycemia between the two groups(P>0.05). Conclusion For severe chest trauma patients with stress hyperglycemia, intensive insulin therapy can effectively improve the immunity, inhibit the inflammatory reaction, reduce the complication incidence, restore ventilation function and improve survival rate.