Objective:To explore the application effect of 5E nursing guided by empowerment theory in patients undergoing liver cancer resection.Methods:Using the purposive sampling method, a total of 88 patients who underwent liver cancer resection surgery in Zhumadian Central Hospital from July 2020 to July 2022 were selected as the research objects. They were divided into the control group ( n=44) and the observation group ( n=44) by the random number table method. The control group was given 5E nursing, while the observation group was given 5E nursing guided by empowerment theory. The improvement of gastrointestinal function between the two groups was compared by the first anal defecation time, the first anal exhaust time and the recovery time of bowel sound. Visual Analogue Scale (VAS) was used to evaluate postoperative pain, General Self-Efficacy Scale (GSES) was used to evaluate self-efficacy, and hope level was assessed by Herth Hope Index (HHI). After treatment, the compliance and occurrence of digestive tract discomfort were compared between the two groups. Results:The first anal defecation time, first anal exhaust time and bowel sound recovery time in observation group were less than those in control group ( P<0.05). Postoperative pain score of observation group was lower than that of control group 48 hours after operation ( P<0.05). After nursing, the GSES, HHI and compliance scores of the observation group were higher than those of the control group ( P<0.05), and the incidence of gastrointestinal discomfort symptoms in the observation group was lower than that in the control group ( P<0.05) . Conclusions:The 5E nursing guided by empowerment theory can effectively improve the compliance, self-efficacy and hope level of liver cancer resection patients, reduce pain, promote postoperative recovery and reduce the incidence of gastrointestinal discomfort symptoms.

Autoimmune hepatitis (AIH) is an immune-mediated chronic inflammatory liver disease. At present, standard treatment is effective in most AIH patients, and second- or third-line pharmacotherapy can be selected for patients who have suboptimal response to standard treatment or cannot tolerate the side-effects of the drugs. Novel therapies are undergoing clinical trials with the further exploration of the pathogenesis of AIH. This article reviews the current research advances in pharmacotherapy for AIH.

Objective:To explore any effect of intermittent hypoxia (IH) on myocardial energy metabolism and its mechanism.Methods:Twenty-one male Sprague-Dawley rats were randomly divided into a sham operation group, a myocardial infarction group and an observation group. The latter two groups received occlusion of the left anterior descending coronary artery. The observation group then lived in an hypoxic environment intermittently for 4 hours/day, 5 days/week for four weeks, while the other 2 groups were exposed to a normal level of oxygen. The ejection fraction of the left ventricle (LVEF) was measured at 1 week after the modeling and 4 weeks after the start of the intervention. Also at that point myocardial fibrosis, mitochondrial structure, ATP content, and the protein expressions of adenosine monophosphate-activated protein kinase alpha1 (AMPKα1) and sirtuins protein family member 3 (SIRT3) were assessed in all three groups.Results:A significant decrease in the LVEF, the number of mitochondria, ATP content, AMPKα1 and SIRT3 protein were observed in the infarction group compared with the sham group. There was also a significant increase in the myocardial fibrosis index. Moreover, the LVEF decreased significantly and the myocardial fibrosis index had increased significantly in the observation group compared with the sham operation group, though the two groups exhibited no significant differences the number of mitochondria, ATP content, or the expression of AMPKα1 or SIRT3. Compared with the myocardial infarction group, in the observation group there was a significant increase in the LVEF, the number of mitochondria, ATP content, and the expression of AMPKα1 and SIRT3 protein, with a significant decrease in the fibrosis index. AMPKα1 and SIRT3 level were positively inter-correlated and positively correlated with LVEF and ATP content.Conclusions:IH intervention can promote ATP synthesis and improve mitochondrial structure by regulating the AMPKα1/SIRT3 pathway, reducing myocardial fibrosis and enhancing cardiac function.

The gross specimens and tissue slices used for traditional experimental pathology curriculum are fragile, and some specimens or slices are difficult to be supplemented. Besides, the classroom and schedule for experimental pathology teaching are inflexible. Therefore, the teaching effects for experimental pathology course are limited. The development of digital technology has promoted the teaching reform of medical experimental curriculum. We have digitalized the gross specimens and tissue slices to preserve and expand the samples, and constructed pathological sample repository containing both physical samples and digital samples. Furthermore, we have established a platform for remote access, and thus improved the flexibility and autonomy of study for experimental pathology curriculum. Additionally, we have integrated clinical information of the teaching samples, and interpreted the specimens with the assistance of two-dimensional code technology and voice broadcast technology, to realize human-computer interactive learning. The questionnaire shows that the application of pathological sample repository in experimental teaching has improved student learning effect and recognition.

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.

Objective To observe the clinical study of Xiaoaiping tablet combined AP regimen in the treatment of unresectable advance endometrial carcinoma. Methods A total of 268 patients with advance endometrial carcinoma in our hospital were divided into treatment group and control group, 134 cases in each group. The control group was treated by AP regimen and the treatment group was given Xiaoaiping tablet combined AP regimen. The treatment was 3 weeks per course, 4 periods performance, and the 2 year follow-up. After the treatment, the immune index, including IgG, IgA, IgM, CD3+ and CD4+ were detected by a chemical lighting method in the 2 groups. The KPS scores were observed to evaluate the life quality in the 2 groups. During the treatment, the adverse effects of chemotherapy in patients were observated during the treatment. And the survival rates, overall survival and progression-freely-survival were also observed. Results After the treatment, the control rate and efficiency rate were 86.5％ (116/134) and 64.2％(86/134) in treatment group, while the control rate and efficiency rate were 76.9％ (103/134) and 52.2％(70/134) in control group, where there were significantly difference in control rate and efficiency rate (Z values were 3.542 and 3.871, P values were 0.041 and 0.039). After the treatment, the levels of IgG, Ig A, IgM, CD3+ and CD4+ in treatment group were significantly higher than control group (t values were 4.725, 4.930, 4.259, 4.571 and 4.006, P<0.01). After the 1st-4th period of treatment, the KPS scores in treatment group were significantly higher than the control group (t values were 3.124, 3.452, 3.612 and 3.712, P<0.05). After the treatment, the PFS, OS, 1 year survival rate and 2 year survival rate were significantly lower in treatment group than control group (t values were 4.241, 4.421, 3.735 and 3.982, P<0.05). Conclusions The Xiaoaiping tablet combined AP regimen in the treatment of unresectable advance endometrial carcinoma has a good effect, could promote the immune function, decease the adverse effects and prolong the survival time in the patients.

Objective To observe the effect of transcranial direct current stimulation (tDCS) with mirror neuronal rehabilitation training system (MNST-V1.0) in post-traumatic unconscious patients after severe craniocerebral injury. Methods A prospective, self controlled and open-label method was used. Thirty-six post-traumatic unconscious patients with severe craniocerebral injury from January 2016 to July 2017 were selected. Four cases of the patients did not complete the treatment and the last 32 cases completed the study. All patients were given routine wake-up therapy, and tDCS combined with MNST-V1.0 (20 min/time, 1 time/d, 6 times/week, a total of 8 weeks) was given at the same time. The Glasgow coma scale (GCS), JFK coma recovery scale and Four coma rating scale before treatment and 2, 4, 8 weeks after treatment were recorded. Results The scores of open reaction, language and motor response score of GCS 2, 4, 8 weeks after treatment were significantly higher than those before treatment:(1.56 ± 0.82), (2.06 ± 1.01) and (3.11 ± 1.45) scores vs. (1.00 ± 0.45) scores, (2.23 ± 1.06), (2.56 ± 1.08) and (3.02 ± 1.04) scores vs. (1.00 ± 0.61) scores, (2.79 ± 1.12), (3.22 ± 1.33) and (4.44 ± 1.07) scores vs. (1.00 ± 0.54) scores, and there were statistical differences (P ＜ 0.01 or ＜0.05). The scores of hearing, vision, movement, speech response, communication and arousal of JFK coma recovery scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.01). The scores of open reaction, sport reaction, brainstem response of Four coma rating scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.05); there was no statistical difference in respiratory score of Four coma rating scale before and after treatment (P＞0.05). Conclusions The tDCS combined with MNST-V1.0 can improve the consciousness level in post-traumatic unconscious patients with severe craniocerebral injury, and have the effect of promoting awakening.

Background:Chronic constipation is a major cause of impaired quality of life in modern society. Reasonable and effective management of chronic constipation could be achieved based on the principle of evidence-based medicine and the modern concept of constipation,and this is a challenge facing the clinicians. Aims:To investigate the role of barium-based colonic transit detection in diagnosis and treatment of chronic constipation. Methods:Fifty patients with chronic constipation from Apr. 2013 to Oct. 2014 at the First Hospital of Shanxi Medical University were recruited and randomly allocated into two groups,control group and individualized treatment group. Patients in individualized treatment group received 20 barium markers orally and abdominal plain radiography was performed 48 and 72 hours later,respectively for calculating the colonic transit index. According to the type of colonic transition and the characteristics of colonic motility estimated by colonic transit index and clinical manifestations,an individualized therapeutic regimen was formulated and the efficacy was evaluated. Patients in control group were treated empirically according to the clinical manifestations. Results:Mosapride and lactulose or polyethylene glycol were administered orally in control group;when abdominal pain or abdominal distension was predominant,pinaverium bromide or trimebutine was used respectively instead of mosapride. Barium-based colonic transit detection revealed that 9 patients in individualized treatment group were slow transit constipation,6 were outlet obstructive constipation and 8 were the mixed type. After 2 weeks of empirical or individualized treatment,the defecation rates of the two groups were 24. 0%(6 / 25)and 52. 2%(12 / 23)within 24 hours and 64. 0%(16 / 25)and 87. 0%(20 / 23)within 48 hours,respectively(P all < 0. 05). Conclusions:Barium-based colonic transit detection is a simple,economical and practical modality for guiding the individualized treatment in patients with chronic constipation.

Objective To study basic thyroid stimulating hormone (bTSH) levels impact on outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in Qinghai.Methods Totally 282 cases with IVF cycles and 93 cases with ICSI cycles were studied prospectively,according to bTSH level,patients were divided into four groups.Reproduction rate,clinical pregnancy rate,miscarriage rate and live birth rate were studied among four groups.Results (1) In 375 cases with IVF/ICSI cycles,bTSH was positively correlated with abortion rate (r=0.42,P=0.04),but live birth rate and growing rate showed negative correlations with bTSH (r=-0.42,-0.28; P=0.04,0.03).bTSH and the number of eggs,the number of fertilized eggs,the number of embryos,biochemical pregnancy rate,and clinical pregnancy rate were no significant correlation (all P＞0.05).(2) Among women at group of ≤1.7,＞1.7 and ≤2.5,＞2.5 and ≤3.5,＞3.5 mU/L,the implantation rates were 28.7％,27.3％,37.7％ and 19.2％,live birth rates were 80.9％,75.0％,82.7％,and 59.8％,abortion rates were 19.0％,15.0％,16.7％,40.1％; they all showed significant difference (all P＜0.05).Abortion rate in women with high bTSH level was higher than that of women with lower bTSH level,however implantation rate,live birth rate in women with high bTSH level were lower.Conclusion When bTSH level is ＞3.5 mU/L,the abortion rate were increased,but live birth rate,rate of implantation were decreased.

Objective To Study the effect of thyroid peroxidase-Ab (TPO-Ab) on in vitro fertilization and embryo transfer (IVF-ET) ending. Methods From March 2011 to October 2013, a total of 378 assisted reproduction cycles in Reproductive Medical Center of Qinghai Provincial People ’s Hospital were retrospectively analyzed in. Experiment group included 69 cycles from patients with positive thyroid peroxidase antibody and normal thyroid function and control group 309 cycles from those with negative thyroid peroxidase antibody and normal thyroid function. Results IVF fertility rate (79.76%) and high quality embryo rate (46.59%) in experiment group were significantly lower than those in control group (84.08%, 54.49% respectively) and the difference was statistically significant (P < 0.05); abortion rate (33.33%) in experiment group was obviously higher than that in control group (16.11%), which was statistically significant (P < 0.05). Conclusion Positive thyroid peroxidase antibody exerts adverse effects on IVF-ET ending since TPO-Ab reduces IVF fertilization rate and high quality embryo rate and increases the rate of abortion.