Autoimmune pancreatitis is a special type of chronic pancreatitis that can lead to abnormal pancreatic exocrine function in patients. Autoimmune pancreatitis comorbid with pancreatic exocrine insufficiency has a complex pathogenesis， and there is limited research on this topic， leading to the lack of understanding of such patients in clinical practice. This article introduces the epidemiology of autoimmune pancreatitis， briefly describes the pathogenesis of pancreatic exocrine insufficiency caused by autoimmune pancreatitis， and summarizes the various detection methods for pancreatic exocrine function， nutritional assessments， lifestyle management， and drug therapy， in order to strengthen the understanding of autoimmune pancreatitis comorbid with pancreatic exocrine insufficiency and improve the clinical diagnosis and treatment of pancreatic exocrine insufficiency.

Objective:To conduct the visual analysis of emergency palliative care based on the Web of Science database.Methods:The literature on emergency palliative care collected from 2012 to 2022 was systematically searched in the Web of Science core collection. CiteSpace software was used for visual analysis.Results:A total of 630 articles were included, and the number of publications was on the rise. The country with the highest number of publications was the United States, with 8 out of the top 10 institutions in terms of publication volume coming from the United States. The author with the highest number of publications was Grudzen. The top 10 journals in terms of citation frequency were mostly specialized journals on palliative care and first aid. The results of keyword analysis showed that a total of 15 clustering labels and 20 emergent words were output, reflecting the changes of key research objects, main research types and areas of concern.Conclusions:At present, nursing research in this field is in the development stage in China. We can draw on the practical experience of foreign countries to further explore the emergency palliative care model and service system based on China's national conditions.

The timely use of screening tools to assess the palliative care needs of emergency patients can provide decision-making basis for patient referral and help patients receive palliative care in a timely manner.This paper reviews the palliative care needs screening tools for emergency patients at home and abroad,describes their development methods,scoring criteria and application status,compares and analyzes their characteristics and shortcomings.It aims to provide references for the localized development and application of palliative care needs screening tools in emergency patients.

Objective:To compare the diagnostic efficacy of 22 G fine needle aspiration (FNA) needles and 22 G end-cutting fine needle biopsy (FNB) needles for solid pancreatic lesion using both cytological and histological examination.Methods:Clinical data of 116 patients who underwent endoscopic ultrasound-guided fine needle aspiration/biopsy (EUS-FNA/FNB) at the Digestive Endoscopy Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2022 to March 2023 were retrospectively analyzed. Sixty-three patients sampled with 22 G FNA needles were the FNA group, and 53 sampled with 22 G FNB needles were the FNB group. The diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and cytological and histological diagnostic yield of FNA needles and FNB needles for solid pancreatic lesions were compared.Results:There were no significant differences in age, gender, lesion location, lesion size, or the number of passes between the FNA group and the FNB group ( P>0.05). There were no significant differences in the diagnostic accuracy [93.7% (59/63) VS 90.6% (48/53), P=0.730], sensitivity [93.0% (53/57) VS 90.2% (46/51), P=0.732], specificity [100.0% (6/6) VS 100.0% (2/2), P=1.000], positive predictive value [100.0% (53/53) VS 100.0% (46/46), P=1.000] and negative predictive value [60.0% (6/10) VS 28.6% (2/7), P=0.335] of combined cytology and histology in distinguishing benign and malignant lesions between the two groups. In the FNA group, the diagnostic accuracy of combined cytology and histology was higher than cytology alone [93.7% (59/63) VS 81.0% (51/63), P=0.008], and was higher than histology alone without statistical significance [93.7% (59/63) VS 87.3% (55/63), P=0.125]. In the FNB group, the diagnostic accuracy of combined cytology and histology was higher than cytology alone [90.6% (48/53) VS 69.8% (37/53), P=0.001], but not than histology alone [90.6% (48/53) VS 90.6% (48/53)， P=1.000]. For solid masses located in pancreatic body/tail, the diagnostic accuracy for malignancy by histology using FNB needles tended to be higher than that of FNA needles [100.0% (17/17) VS 81.3% (26/32), P=0.080]. Conclusion:Both FNA needles and FNB needles exhibit adequate diagnostic yield for solid pancreatic masses when combining cytology and histology. FNB needles may offer a higher histological diagnostic yield.

Objective:To observe the pathological changes of different intestinal parts and the changes of intestinal barrier function in mice with acute necrotizing pancreatitis (ANP) induced by sodium taurocholate.Methods:A total of 18 male C57BL/6 mice were randomly divided into sham operation group, ANP 24 h group and ANP 48 h group with 6 mice in each group. The ANP model was established by retrograde injection of 2 μl/g 5% sodium taurocholate into the pancreaticobiliary duct. The sham operation group only underwent intubation. The survival status was recorded. The pathology of pancreatic and intestinal tissues were observed using hematoxylin-eosin staining, and the pathological scores were evaluated. The activities of serum amylase and lipase were measured by automatic biochemistry analyzer. Serum D-lactate levels were detected by ELISA. The expression of tight-junction proteins ZO-1 and occludin in small intestinal tissue was detected by Western blotting.Results:The survival rates of sham operation group, ANP 24 h group and ANP 48 h group were 100%, 36.4% and 25.0%, respectively. The pancreatic pathological scores of sham operation group, ANP 24 h group and ANP 48 h group were (0.67±0.82), (10.58±0.64) and (8.81±1.55); the serum amylase activities were (479.14±86.42), (5998.72±2096.31) and (3055.43±2336.5)U/L; the serum lipase activities were (18.56±3.84), (558.20±559.65) and (112.58±94.91)U/L. The pancreatic pathological scores, serum amylase and lipase levels in ANP group were higher than those in sham operation group, and the increase in ANP 24 h group was more significant, and the difference was statistically significant (all P value <0.05). The upper small intestine pathological scores in different groups were (0.17±0.41), (2.11±1.41) and (1.61±0.80); The lower small intestine pathological scores were (0.17±0.41), (1.00±0.76) and (1.06±0.25); the colonic pathological scores were (0.33±0.52), (0.67±0.82) and (0.67±0.52), respectively. The serum D-lactic acid level was (388.92±126.30), (2159.11±386.12) and (307.69±141.18) μmol/L. The expression of ZO-1 was (0.87±0.08), (0.19±0.18) and (0.50±0.19); the expression of occludin was (0.98±0.04), (0.13±0.08) and (0.69±0.04). The pathological scores of upper and lower segments of small intestine in ANP 24 h group and ANP 48 h group were significantly higher than those in the sham operation group (all P value <0.05). There was no significant difference on colonic pathological score among the three groups. The serum D lactate level in the ANP 24 h group was significantly higher than that in the sham operation group ( P<0.05), but there was no significant difference between the ANP 48 h group and the sham operation group. The expression of ZO-1 and occludin was decreased in ANP group compared with that in the sham operation group ( P value <0.05). Conclusions:ANP mouse model was successfully induced by sodium taurocholate, and the intestinal pathological changes were mainly concentrated on the small intestine, especially upper part of small intestine. The dysfunction of intestinal barrier was significantly aggravated within 24 hours after modeling, and the intestinal barrier function gradually recovered after 48 hours.

AIM: To investigate the expression and significance of MAPK-interacting kinase-2 ( Mnk2 ) and eukaryotic initiation factor 4E ( eIF4E) in the patients with resected esophageal squamous cell carcinoma ( ESCC ). METHODS:The protein expression of Mnk2 and eIF4E in ESCC tissues (98 cases) and normal esophageal tissues (20 cases) were assessed by immunohistochemistry (IHC), and their correlations with clinicopathological features were statisti-cally analyzed.RESULTS:The over-expression rate of Mnk2 and eIF4E was 68.4%(67/98) and 61.2%(60/98), re-spectively.The expression of Mnk2 had a positive correlation with eIF4E (P<0.05).Clinicopathologic analysis showed that Mnk2 expression was significantly correlated with T classification ( P<0.05 ) and clinical stage ( P<0.05 ) .CON-CLUSION:The over-expression of Mnk2 was significantly related to the tumor invasive depth , TNM stages and expression of eIF4E in ESCC.Expression of Mnk2 and eIF4E may have a cooperative formation mechanism in the development of ESCC.

Objective To explore the relationship between histological chorioamnionitis(HC),fetal vasculitis(FV)and the morbidity of neonatal respiratory distress syndrome(RDS).Methods Three hundred and forty-seven cases of infants at the gestational ages of 28 +0 to 31 +6 weeks who were admitted to the Neo-natology Department of our hospital from October 2009 to June 2013 were analyzed retrospectively.They were divided into four groups according to the occurrence of HC and FV,namely,HC positive group and HC negative group,FV positive group and FV negative group.The patients in the HC positive group were further divided into FV positive group and FV negative group according to the occurrence of FV.The morbidity of RDS among above-mentioned groups was compared.Results The clinical characteristics including propor-tion of male,gestational age,birth weight,cesarean delivery,antenatal corticosteroid use,gestational hyperten-sion,gestational diabetes and cholestasis of pregnancy showed no statistically significant difference among all the groups(P 〉0.05).The incidence of RDS in the HC positive group(145 cases)was 49.6%(72 cases), which was significantly lower than that in the HC negative group(67.3%,126 /202,P 〈0.05).The incidence of RDS in FV positive group(64 cases)was 42.2%(27 cases),which was significantly lower than that in FV negative group(63.3%,179 /283,P 〈0.05)In the HC positive group(145 cases),the incidence of RDS in FV positive group (64 cases)was 42.2% (27 cases),and 55.6% (45 cases)in FV negative group (81 cases),which showed no significant difference(P ﹦0.01 ).Conclusion (1 )HC or FV can reduce the incidence rate of RDS in premature infants.(2)HC combined FV cannot furtherly reduce the incidence of RDS.

Objective To investigate the effect of granulesten on hs-CRP and lipid in patients with stroke.Methods 76 patients with acute ischemic stroke were selected and randomly divided into two groups.38 cases in the control group were treated by conventional therapy, 38 cases in the experiment group were treated on the basis of the control group with granulesten.hs-CRP, IL-6, Hcy, and lipid fat were detected and the clinic effect were compared after the treatment.ResuIt Compared with control group, hs-CRP, IL-6, and Hcy of the experiment group were lower(P<0.05), TC, TG and LDL-C were lower, HDL-C was higher ( P<0.05 ) , the clinic effect was higher ( P<0.05 ) , the rate of side effect was higher ( P<0.05 ) . ConcIusion Granulester can significantly reduce serum hs-CRP, IL-6 and Hcy levels, improve blood lipid metabolism, improve the clinical efficacy, and adverse reactions are mild, it has important significance for patients with acute ischemic stroke.

BACKGROUND:It remains hard to judge characterization of lesion tissues using two-dimensional sectional image at present. Medical three-dimensional reconstruction technique could obviously improve work efficiency and accuracy of medical working staff on disease diagnosis.
OBJECTIVE:To develop a three-dimensional medical visualization system can rebuild three-dimensional model of corresponding parts by reading DICOM data, and observe the appearance of affected hip joint using reconstructed models.
METHODS:A three-dimensional (3D) medical visualization system was developed using the MFC in a PC with Windows XP operating system, development environment VC++6.0, VTK 5.6 instal ation, and necessary settings were made. Precise procedures are as fol ows: ① create a drawing object; ② create a drawing window, and draw objects was added in draw window; ③ read the CT image sequences, and set the path of the read image sequence; ④ isosurface (generate triangular facets) were extracted using MC algorithm, depending on the gray, skin and bones. Data of the input image sequence were set;gray value of tissue contour was set; ⑤the establishment of a V-belt objects and data mapping object; ⑥ graphics rendering, to receive the properties of the geometric data, and a different colors and transparency of bones and skin were set; ⑦ the viewing position was set to observe the position of the object and focus; ⑧ to create a human-computer interaction function.
RESULTS AND CONCLUSION:VC++6.0 and VTK could meet the needs of medical 3D visualization systems development. Developed 3D visualization system software could perform 3D reconstruction through reading CT images of DICOM format files. Thus, the relevant parts of the reconstructed 3D model could be observed by rotating, zooming, and panning so as to visual y observe the bone structure of hip joint, fractured appearance and type. It provided a reference for relevant therapy and operation.

Objective To explore the correlation between histological chorioamnionitis (HC) and brain injury in preterm infants. Methods Three hundred and forty-seven cases of infants at the gestational age of 28-31 weeks who were admitted to the neonatology department of our hospital were analyzed retrospectively. They were divided into the HC group and the control group according to the pathological examination. Moreover, HC group was divided into FV group and non-FV group according to the pathological findings of fetal vasculitis (FV). Based on the findings of periodical ultrasonography, the incidences of periventricular leukomalacia (PVL), periventricular-intraventricular hemorrhage (PVH-IVH), and the PVL+PVH-IVH were compared among groups. Results The incidences of PVL in the HC group and the control group were 17.9% and 10.3%respectively. The incidences of PVL+PVH-IVH in the two groups were 5.5%and 1.48%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in the two groups were 28.9%and 26.2%respectively, and the difference between two groups was not signiifcant (P>0.05). In the HC group, the incidences of PVL in FV group and non-FV group were 28.1%and 9.87%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in FV group and non-FV group were 34.3%and 24.7%respectively, and the difference between two groups was not signiifcant (P>0.05). The incidences of PVL+PVH-IVH in FV group and non-FV group were 7.81%and 3.70%respectively, and the difference between the two groups was not have signiifcant (P>0.05). Conclusions HC may increase the ncidences of PVL and PVL+PVH-IVH in the preterm infants, while its effect is minimal on PVH-IVH. FV could increase the incidence of brain injury in preterm infants.