目的探讨胆囊结石病引起胆道内瘘的原因，提高其诊断和治疗水平。方法收集我院1990～1999年收治的胆道内瘘患者46例，并对其病因、诊断与治疗进行分析。结果胆囊十二指肠瘘18例（39.1%），胆囊结肠瘘8例（17.4%），胆囊与胃、空肠内瘘各1例（4.3%）； 胆囊胆管瘘18例（39.1%）。术后出现并发症4例（8.7%），死亡1例（2.2%），治愈率为97.8%。结论重视本病的临床表现及术前、术中检查，选择恰当手术方式，可减少死亡与并发症的发生。
目的：探讨医院收治甲型H1N1流感患者的感染控制策略。方法：通过扎实的全员培训、考核,使所有工作人员掌握医院感染控制技能;并在收治中国内地首例甲型H1N1流感的诊疗过程中,对医疗操作全过程的医院感染控制措施和手段,实施层级监督。结果：在收治中国内地首例甲型H1N1流感的诊疗过程中未发生院内感染,无第二代患者出现。结论：应急工作常态管理,及时制定应急预案,监督落实医院感染控制措施,是患者成功有序诊疗和院感控制的有力保证。
To explore the feasibility of mesenchymal stem cells (MSCs) acting as seed cells in tissue engineering, we isolated human bone marrow MSCs and differentiated them into vascular endothelial-like cells (ELCs) in vitro. Bone marrow mononuclear cells (BMSCs) were isolated by the method of percoll density centrifugation, and seeded in Dulbecco Modified Eagle Medium supplemented with 10% fetal bovine serum. MSCs were purified through multiple adherent cultures, and differentiated into ELCs induced by endothelial cell growth medium-2 (EBM-2) medium containing vascular endothelial growth factor (VEGF), human fibroblast growth factor (hFGF), insulin like growth factors 1 (IGF-1), and human epidermal growth factor (hEGF). The relative biologic characteristics of ELCs including cell morphology and phenotype were studied by inverted microscope and flow cytometry. The induced cells were identified by immunofluorescence with CD31 and Von Willebrand factor (vWF). The results showed that the morphology of MSCs was long-spindle and vortex-like growth. After induction of differentiation, the cells were round, and similar to vascular endothelial cells (ECs). Flow cytometric analysis revealed that ELCs expressed ECs specific surface markers of CD31 and vascular endothelial cadherin (VE-cadherin), but not CD133. Immunofluorescence results also confirmed that ELCs expressed CD31 and vWF. The results suggested that ELCs possed similar cell biological characteristics with ECs. In one word, human MSCs derived from bone marrow have the potential to differentiate into ECs in vitro,and show clinical feasibility acting as ideal donor cells of vascular tissue engineering.
Objective To explore the influencing factors of sleep quality of the elderly in Chengdu community and put forward corresponding nursing strategies. Methods The elderly in four communities in Chengdu were selected by convenient sampling method from January to June 2021. The elderly in the community were investigated and analyzed by general information questionnaire, Interpersonal Relationship Integrative Diagnostic Scale (IRIDS) and Pittsburgh Sleep Quality Index (PSQI). Multiple linear stepwise regression was used to analyze the factors affecting the sleep quality of the elderly. Results A total of 232 elderly were investigated and 211 were finally included. The total score of PSQI in the elderly was positively correlated with the score of interpersonal conversation disturbance (r=0.297, P<0.05) and the score of treating people disturbance (r=0.208, P<0.05). The results of multiple linear stepwise regression analysis showed that physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were the main influencing factors of sleep quality in the elderly. Conclusions The community elderly in this study had better sleep quality. Physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were all important factors affecting the sleep quality of the elderly. Community nursing staff should pay more attention to the sleep quality of the elderly, put forward measures to improve the related factors leading to sleep disorders, encourage the elderly to take physical exercise. They should also provide psychological counseling and interpersonal communication skills for the elderly with interpersonal troubles and help expand the communication platform to improve sleep quality of the elderly in the community.