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Objective To investigate the application effect of enhanced recovery after surgery in perioperative nursing of patients with choledochojejunostomy. Methods Totally 80 patients undergoing choledochojejunostomy were randomly divided into the control group and observation group, with 40 cases in each group. Patients in the control group received routing care during the treatement, and those in the observation group received perioperative nursing interventions based on the theory of enhanced recovery after surgery. Primary outcomes were first anal exhaust time, length of hospital stay, hospitalization costs and incidence of postoperative complications. Secondary outcomes were time to remove the gastric tube, time to remove the urinary catheter, time to food-taking, time to off-bed activity and volume of fluid infusion. Results The first anal exhaust time and length of hospital stay in the observation group were shorter than those in the control group (P＜0. 01). The hospitalization costs in the observation group was lower than that in the control group (P＜0. 01). The time to remove the gastric tube, time to remove the urinary catheter and time to off-bed activity in the observation group were shorter than those in the control group (P＜0. 01). The volume of fluid infusion in the observation group was less than that in the control group (P＜0. 01). The incidence rate of complications in the observation group was lower than that in the control group (P＜0. 05). Conclusion The enhanced recovery after surgery is effective and safe in perioperative nursing of patients with choledochojejunostomy, it has a positive effect on reducing the incidence of postoperative complications. (目的 探讨基于加速康复外科理念的护理干预在胆肠吻合术患者中的应用方法及效果。方法 选择2018年1月—2020年8月住院行胆肠吻合术的80例患者为研究对象, 按照随机分组方法将患者分为对照组和观察组, 各40例。对照组给予常规护理, 观察组实施基于加速康复外科理念的护理干预。主要指标: 首次肛门排气时间、住院时间、住院费用、并发症的发生率; 次要指标: 拔除胃管时间、尿管时间、进食时间、下床时间、输液量。结果 观察组首次肛门排气时间、住院时间均较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组住院费用较对照组减少, 差异有统计学意义(P＜0. 01)。观察组拔除胃管时间、拔尿管时间、进食时间以及下床时间较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组输液量也明显少于对照组, 差异有统计学意义(P＜0. 01)。观察组并发症发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 在胆肠吻合术患者围术期护理中的应用加速康复外科理念安全有效, 对降低术后并发症发生率具有积极意义。)

目的 评估绝经激素治疗与卒中发生之间的相关性。 方法 计算机检索PubMed、Embase和Cochrane图书馆从建库到2022年1月5日已经发表的关于绝经后女性采取绝经激素治疗的随机对照试验以及观察性研究，其中随机对照试验治疗方式必须为口服激素治疗，且随访的时间应超过6个月。探索绝经激素治疗与卒中之间的相关性，结局指标为研究人群的卒中发生率。 结果 绝经激素治疗随机对照试验的meta分析纳入了7项研究，35 776例健康女性中共有566例（1.58%）发生卒中，接受绝经激素治疗的18 337例健康女性中共有332例（1.81%）发生卒中，对照组17 439例中共有234例（1.34%）发生卒中，绝经激素治疗的健康女性卒中发病率是对照组的1.40倍（RR 1.40，95%CI 1.19～1.65）。绝经激素治疗观察性研究的meta分析纳入了3项研究，167 770例女性中共有1425例（0.84%）发生卒中，接受绝经激素治疗的61 117例女性中共有513例（0.84%）发生卒中，对照组106 653例女性中共有912例（0.86%）发生卒中，绝经激素治疗组与对照组之间差异无统计学意义（RR 0.96，95%CI 0.86～1.07）。 结论 绝经激素治疗与卒中发生之间可能无明显的相关性。 Abstract: Objective To evaluate the association between menopausal hormone therapy and stroke. Methods The PubMed, Embase and Cochrane Library were retrieved for randomized controlled trials (RCTs) and observational studies on menopause hormone therapy for postmenopausal women published from inception to January 5, 2022. The treatment in RCTs must be oral hormone therapy, and the follow-up time should be over 6 months. The outcome was the incidence of stroke in the subjects of the included studies. The association between menopausal hormone therapy and stroke was analyzed. Results The meta-analysis of RCTs included 7 studies including 35 776 healthy women, and stroke occurred in 566 women (1.58%). Of 18 337 healthy women who received menopausal hormone therapy, stroke occurred in 332 women (1.81%). In the control group, stroke occurred in 234 (1.34%) among 17 439 healthy women. The incidence of stroke in healthy women who received menopausal hormone therapy was 1.40 times higher than that in those who did not receive menopausal hormone therapy (RR 1.40, 95%CI 1.19-1.65). The meta-analysis of observational studies on menopausal hormone therapy showed that 1425 (0.84%) stroke occurred in 167 770 women from 3 studies. Stroke occurred in 513 (0.84%) of 61 117 women receiving menopausal hormone therapy and 912 (0.86%) of 106 653 women in the control group, and there was no statistical difference in the incidence of stroke between the menopausal hormone treatment group and the control group (RR 0.96, 95%CI 0.86-1.07). Conclusions There may be no significant association between menopausal hormone therapy and stroke.

AIM: To investigate the effects of cigarette smoke exposure during adolescence on the inflammatory response mediated by microglia in the prefrontal cortex of mice, and its impact on learning and memory functions in adulthood. METHODS: 72 two-week-old healthy male Kunming mice, with each weighing (11. 0±1. 5) g, were randomly divided into control and cigarette exposure groups (n=36 per group). The mice in the cigarette exposure group were passively exposed to 6 cigarettes daily for 10 weeks. At three time points of 4-week-old (infancy), 8-week-old (adolescence), and 12-week-old(adulthood), six mice were selected from each group to have their neurobehavioral and pathological changes examined. In particular, the step-down test, three-chamber social interaction test, and novel object recognition test were used to detect changes in learning and memory abilities and cognitive behavior. Immunofluorescence testing was performed to detect the morphology, number of synapses, and expression of inflammatory factor apoptosis-associated speck-like protein containing a CARD (ASC) around the microglial cells in the prefrontal cortex of mice in each group. Western blot was performed to assess the expression levels of synaptophysin (SYP) and postsynaptic density protein-95 (PSD-95) in the cerebral cortex of mice in each group. Enzyme-linked immunosorbent assay (ELISA) was performed to detect the protein expression of tumor necrosis factor-α(TNF-α), interleukin 1β(IL-1β), and IL-6 in the prefrontal cortex. RESULTS: (1) In the step-down test, the latency of mice at 8 and 12 weeks of age was significantly shortened, and the number of errors was significantly increased in the cigarette exposure group compared with the age-matched control group (P<0. 01). In addition, the social recognition time and exploration time for novel objects were prolonged (P< 0. 05).(2) Immunofluorescence assays revealed that exposure to cigarette smoke in mice, at both 8 and 12 weeks of age, resulted in a reduction of SYP-positive puncta within the prefrontal cortex. Concurrently, there was an observed increase in the number of Iba1-positive microglia, which exhibited an activated phenotype, as well as an elevation in ASC-positive puncta in proximity to the microglia. Western blot further revealed reduced expression of synaptophysin protein SYP and PSD-95 in the cerebral cortex of the mice at 8 and 12 weeks of age in the cigarette exposure group (P<0. 05). (3) ELISA showed increased levels of inflammatory factors TNF-α, IL-1β, and IL-6 in the prefrontal cortex of the mice at 8 and 12 weeks of age in the cigarette exposure group (P<0. 05). CONCLUSION: Exposure to cigarette smoke during adolescence in mice may result in the enhanced secretion of inflammatory factors through the activation of microglia in the prefrontal cortex. This activation can alter microglial function and induce synaptic damage, consequently impairing learning, memory, and cognitive abilities in adulthood. [ABSTRACT FROM AUTHOR]

This paper introduced the design and application of a disposable negative pressure device for collecting drainage fluid specimens. The purpose of this design is to modify the process of collecting drainage fluid specimens, reduce the workload of nurses and avoid the false positive results caused by multiple factors. (本文介绍一种一次性医用负压式引流液标本收集装置的设计与应用方法, 旨在减少留取引流液标本的环节, 节约护士操作时间, 避免留取过程中多环节导致假阳性。)

BACKGROUND: The effective promotion of internal angiogenesis in organoids is a current focal issue in organoid culture. Vascularized organoids, as a newly developed bioculture technology, have significant research and application value in the study of living tissue development, disease formation mechanisms, tissue replacement therapy, and drug screening. OBJECTIVE: To summarize the methods or strategies for vascularization of organoids in recent years, analyze the formation mechanism of vascularization of organoids and the construction strategies, with a view to providing reliable ideas for more in-depth study of the mechanism of organoid genesis and for clinical translation. METHODS: The authors utilized the PubMed and CNKI databases for related formation collection. The keywords were “organoids, vascularization, vascular, vascular development, vessel” in Chinese and English. Finally, 77 papers were included for summarization. RESULTS AND CONCLUSION: (1) The mechanism of vascularization formation in organoid organs involves three key factors, namely seed cells, cytokines, and extracellular matrix. Seed cells provide the essential cell source for vascularized organoids; cytokines play an important role in guiding angiogenesis within organoids, and the extracellular matrix provides an external growth environment for vascular cells, promoting the occurrence of vascularized organoids. (2) The construction strategies of vascularized organoids include cell self-reorganization, microvascular fragment infiltration, transplantation into host, and microfluidic chip. In vitro induction of pluripotent stem cells to differentiate into endothelial progenitor cells can integrate with adjacent tissues and have the potential for angiogenesis, so pluripotent stem cells can be used to construct vascularized organoids by self-reorganization. Microvascular fragments retain their cellular complexity, natural structure, and phenotypic plasticity, which is more conducive to simulating natural microvessels and promoting vascularization of organoids. Transplantation into host is currently the best method to achieve complete blood perfusion in organoids, while microfluidic chip provides a solution for achieving extracorporeal blood supply in organoids. (3) Multiple construction strategies of organoid such as co-differentiation of multiple stem cell types, precise regulation of signaling molecules, microvascular infiltration, and in vivo host transplantation, have introduced vascular components into organoids to some extent, making them closer to the corresponding tissues in terms of function and maturity. However, the challenge of achieving perfusion remains, and so far, only in vivo transplantation in hosts has enabled effective perfusion in organoids. Therefore, organoids still face numerous challenges in terms of vascularization. [ABSTRACT FROM AUTHOR]

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