OBJECTIVE To compare the efficacy of Danning tablet， taurosodeoxycholic acid and ursodeoxycholic acid in preventing the recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography （ERCP）. METHODS The clinical data of 153 patients who underwent ERCP choledocholithotomy from January 2017 to January 2020 in Nantong First People’s Hospital were retrospectively analyzed. According to the different drug treatment received after surgery， patients were divided into three groups， namely， Danning tablet group （group A， 49 cases）， tauroursodeoxycholic acid group （group B， 44 cases） and ursodeoxycholic acid group （group C， 60 cases）. The above groups of drugs are all single-use， starting from 2 weeks after surgery for a course of 180 days. The effects of bile component indicators [total bilirubin （Tbil）， direct bilirubin （Dbil）， alkaline phosphatase （ALP）， glutamyltransferase （GGT）]， lipid metabolism indicators [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， high-density lipoprotein （HDL）]， the occurrence of clinical symptoms （abdominal pain， bloating， nausea， and poor appetite） at 6 months after ERCP， and the recurrence of choledocholithiasis at 6， 12， 18 and 24 months after surgery were compared among 3 groups. RESULTS Compared with before surgery， the serum levels of Tbil， Dbil， ALP， GGT， TC， TG and LDL were significantly reduced （P＜0.05）， while serum HDL levels were significantly increased （P＜0.05） in the three groups at 6 months after surgery. The proportion of patients who experienced abdominal pain， bloating， nausea， and poor appetite at 6 months after surgery was significantly reduced （P＜0.05）. The Tbil levels of groups A and B were significantly lower than those of group C （P＜0.05）， while the Dbil and ALP levels of group A were significantly lower than those of groups B and C （P＜0.05）； however， there was no statistically significant difference in GGT levels among the 3 groups （P＞0.05）. Compared with groups A and C， the levels of four lipid metabolism indicators in group B were significantly improved （P＜0.05）； the proportion of patients with abdominal pain， bloating， and poor appetite in group A was significantly lower than groups B and C （P＜0.05）， but there was no statistically significant difference in the proportion of patients with nausea among the 3 groups （P＞0.05）. At 6，12 and 18 months after surgery， there was no statistically significant difference in the rate of choledocholithiasis recurrence among the 3 groups （P＞0.05）； at 24 months after surgery， the rate of choledocholithiasis recurrence in group A （2.04%） was significantly lower than group B （15.91%） and group C （15.00%） （P＜0.05）. CONCLUSIONS Compared with tauroursodeoxycholic acid and ursodeoxycholic acid， the application of Danning tablet after ERCP is more beneficial to reduce the secretion of bile acid， prevent the recurrence of gallstones， and improve clinical symptoms， but tauroursodeoxycholic acid can significantly accelerate the lipid metabolism of patients compared with the other two drugs.

This paper reviews the application status of wearable devices in the fall of the elderly, including sensing fall situations, predicting fall risk, identifying fall behavior, and real-time positioning technology. This paper also puts forward suggestions for the development of wearable devices for fall management in the elderly, so as to provide a reference for the development of smart aged care applications.

Objective:To analyze the research hotspots of shared decision making in the field of nursing abroad in recent 10 years, and explore the current status and trends in this field.Methods:The subject terms of related literature from 2010 to 2019 included in Web of Science were taken as the research object. Bicomb and gCLUTO were used to perform word frequency analysis and graph clustering analysis, and the clustering results of the visualized hill map were interpreted by combining professional knowledge.Results:Finally, a total of 734 articles were included and published in 297 journals. A total of 30 high-frequency subject words were extracted, accounting for 39.69% of the total frequency. Through co-word cluster analysis, it was found that the research hotspots included five aspects, namely hospice in nursing homes, pediatric ethics, tumor decision making assistance, chronic disease management, and Intensive Care Unit (ICU) collaboration.Conclusions:The research hotspots of shared decision making in the field of nursing abroad in the past 10 years show different characteristics of multi-population, multi-disease, and multi-level. This helps to understand the current research status and development trend of this field, and provides a reference for the development of nursing shared decision making research in my country.

The prevention and treatment of COVID-19 in China is now at a key stage. The tasks faced by the medical organs are fighting against the COVID-19 while providing the medical services orderly. As a Specialist medical institution nationwide, ophthalmic hospitals are resuming receiving patients and performing operations gradually, including precision interruption of the epidemic, prevention of the secondary virus transmission, and avoidance of nosocomial cross infection among health care providers are required. We explored a multifaceted management for the prevention and control of epidemic, with a special focus on the individual protection for patients and medical staffs. A preliminary positive effect can be observed as a result. The main measures taken cover two aspects. On the one hand, 2019-nCoV ribonucleic acid (RNA) detection and hematological indices inspection including C-reactive protein (CRP) and serum amyloid A (SAA) are listed as routine tests of preoperative screening for ocular surgical patients. These tests are required to be completed upon the admission to avoid the possibility of accepting any asymptomatic infected individual and to reduce the risk of nosocomial cross infection. On the other hand, the 2019-nCoV RNA detection is also provided to high-risk employees who visited affected area recently. This assists in obtaining guarantee in both safety and quality of medical services provided, but also helps in lessening the mental and spiritual stress for medical staffs. It is expected that these measures can contribute to the work of our peers of ophthalmology in the prevention and control of COVID-19 and to the safe environment where the medical services are provided, and provide a reference for other outbreak of virus-causing disease.

Objective To observe the changes of peripheral blood lymphocyte subsets in patients with postoperative colorectal cancer before and after chemotherapy, and to evaluate the changes of immune function status. Methods 74 patients with stage Ⅱ-Ⅲ colorectal cancer after radical resection admitted in Zhejiang Cancer Hospital from January to December 2016 were enrolled. 25 non-malignant patients in the same period in our hospital were selected as the control group. Flow cytometry was used to analyze the proportion of peripheral blood lymphocyte subsets at one day before the first, sixth and eighth cycles of adjuvant chemotherapy. Results There were no differences in CD3+ (P =0.1532), CD3+CD4+ (P=0.1107), CD3+CD8+ (P=0.2576) T cells in the peripheral blood between patients with colorectal cancer after radical operation and control group (P>0.05). While CD3+CD56+NKT cells (P=0.0210) and CD3-CD56+NK cells (P=0.0045) in the patients with colorectal cancer after radical operation were significantly higher than those of the control group (P <0.05). There was no significant change in the proportion of NK and NKT cells before 6 cycles of postoperative adjuvant chemotherapy (P>0.05). There was no significant change in the proportion of NKT cells before 8 cycles (P>0.05), and the proportion of NK cells only decreased slightly (19.10±4.63 vs 20.31±4.66, P=0.046). Conclusion The proportion of NK and NKT cells in patients with colorectal cancer after radical resection was significantly higher than that in healthy people, and the expression rate remains stable after adjuvant chemotherapy.

Objective To explore the effect of sitting and lateral sputum aspiration on the retention time of tracheal cannula in patients with neurosurgical tracheotomy. Methods Totally 120 cases of neurosurgery tracheotomy in hospitalized patients complicated with pulmonary infection by random number table method, 58 cases were divided into experimental group and control group 62 examples, two groups of patients with sputum top all joint taps to the back of the chest, the experimental group after taps take seat effectively causes cough; In the control group, the lateral position was used to effectively cough or induce cough, and the daily sputum volume of the two groups of patients was observed. To observe the time when the body temperature was restored to normal after the phlegm of the two groups of patients, the time of the lung auscultation, and the time of the tracheal tube retention. Results Implementing position row of phlegm daily sputum volume within a week the experimental group were (44.84±6.85) ml, (44.60±6.80) ml, (43.79±5.98) ml, (44.38±5.42) ml, (42.22±5.45) ml, (38.12±4.77) ml, (36.88±4.57) ml and control group were(36.13±7.34) ml, (35.15±7.34) ml, (36.13±7.34) ml, (37.13±7.34) ml, (37.13±7.34) ml, (32.97±7.17) ml, (31.35±4.36) ml, the difference had statistical significance (t=4.30-7.31, P<0.01);In the two groups, the time of normal body temperature recovery, the time of hearing and the time of the lung and the time spent in the tracheal tube were compared, and the experimental group were respectively (9.93±2.02) d, (32.33±1.50) d, (37.33±1.50) d, while control group were(15.77±1.05) d, (37.63 ± 2.33) d, (42.63 ± 2.33) d, the difference had statistical significance (t=20.04, 14.71, P<0.01). Conclusions It is better to reduce the retention time of tracheal tube in patients with neurosurgical patients than the lateral position.

Objective To discuss theoretical structure model for the scale of recurrent oral ulcer (ROU) with traditional Chinese medicine characteristics; To lay a theoretical foundation for further developing scale. Methods This study followed international patients reported outcome (PRO) scale development specification, combined TCM theories, including the theory of mouth dominate and five internal organs correlation, uniformed spirit and body, correspondence between human and the universe, seven emotions, constructed theoretical structure of PRO scale of ROU. Results The theoretical structure of PRO scale of ROU included four major areas as physiology, psychology, independence, and society and nature. Conclusion Theoretical model of PRO scale of ROU laies the foundation and provides the oretical guidance for the formulation of PRO scale of the ROU.

Objective To compare the pathogenicity between Ureaplasma urealyticum serotype 1 (Up1)and 8 (Uu8) in the genital tract of BALB/c mice.Methods A total of 48 BALB/c mice were randomly and equally divided into four groups:blank control group receiving no treatment,estradiol group pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with sterial liquid culture media,Up1 and Uu8 groups pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with suspensions of Up1 and Uu8 respectively.Three mice were randomly selected from each group to be sacrificed after the collection of vaginal lavage fluid on day 3,7,14 and 21 after the inoculation.Vaginal and uterine tissue specimens were obtained from these sacrificed mice and underwent hematoxylin and eosin (HE) staining.Vaginal lavage fluid samples were subjected to culture of Uu and measurement of tumor necrosis factor-α (TNF-α).Results No evidences were observed for Uu growth in either the blank control group or estradiol group at any of the time points after the inoculation,with the average level of TNF-α in vaginal lavage fluid being (4.17 ± 0.85) pg/ml at these time points in both groups.Uu grew in all the vaginal lavage fluid samples from the Up1 and Uu8 groups at the four time points,with the color change unit (CCU) value decreasing with time.The level of TNF-α in vaginal lavage fluid peaked on day 14 after the inoculation in the Up 1 ((14.93 ± 1.11) pg/ml) and Uu8 ((27.04 ± 24.26) pg/ml) groups.Both Up1 and Uu8 infection caused acute and chronic inflammatory responses in the mice,which were mainly located in the uterus,and Up1 might cause intrauterine adhesion.Conclusions At the same inoculation concentration,no significant difference is found in the pathogenicity between Up1 and Uu8,both of which appear to mainly cause cervicitis.Upl might be partially responsible for intrauterine adhesion in mice.

Objective To determine Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) sequence types in different geographical areas of China,including Changzhou and Yangzhou cities of Jiangsu province,Wuzhou and Hezhou cities in Guangxi Zhuang Autonomous region,Sanya and Qionghai cities of Hainan province,Jiangmen and Maoming cities of Guangdong province.Methods DNA was extracted using Qiagen DX extraction kits from 88 urine samples which were collected from male patients attending sexually transmitted disease (STD) clinics and positive for nucleic acid amplification test (NAAT) for N.gonorrhoeae.Two rounds of PCR were carried out to amplify the porB and tbpB genes of N.gonorrhoeae followed by gene sequencing.Sequence alignment was performed on the NG-MAST website (http://www.ng-mast.net) to determine the genotype of N.gonorrhoeae.Results The first-round PCR yielded positive results for porB and tbpB in 13.6％ (12/88) and 14.8％ (13/88),respectively,of these urine specimens,and 12 samples were successfully genotyped with the efficiency of genotyping being 13.6％.The amplification efficiency of second-round PCR was enhanced to 71.6％ and 72.7％ for porB and tbpB,respectively,and the efficiency of genotyping increased to 70.5％ (62/88).Compared with the first-round PCR,the second-round PCR showed an increase in amplification efficiency for porB and tbpB by 58.0％ and 57.9％ respectively,as well as in genotyping efficiency by 56.9％.Forty-five genotypes were identified in the 62 samples,including 40 known genotypes and 5 novel genotypes.Of these genotypes,ST1866 was the most abundant (6/62),followed by ST1972 (4/62) and ST3356 (4/62),all of which were from Jiangsu province.The ST532 genotype was identified in 3 samples from Guangdong province,ST2221 genotype in 2 samples from Guangxi Zhuang Autonomous region.Each of the remaining genotypes was identified in only 1 sample and scattered in all of these cities.The 5 novel MAST-genotypes were as follows:porB-892 and tbpB-46 (98％ similarity),porB-130 and tbpB-504 (96％ similarity),porB-2790 and tbpB-32 (99％ similarity),porB-1053 and tbpB-856 (99％ similarity).Conclusions Urine samples can be used for NG-MAST analysis,and two rounds of PCR can enhance the efficiency of genotyping.NG-MAST genotypes appear to be diverse in different geographical areas of China.