Objective To investigate the treatment of combined subclavian artery and brachial plexus injury. Methods Since 1994, we have treated 5 cases of combined subclavian artery and brachial plexus injury. 2 of them were cut wound, 1 gun shot wound, and 2 blunt trauma. 2 cases had combined aneurysm and 1 had combined aneurysm plus A V fistula. According to the sites of subclavian artery injury, vein graft( 1 case) , suture repair( 1 cases) and ligation (1 case) were performed. The 2 cases of blunt trauma underwent only neurolysis because of masses of hematoma and tissue adhesion. Results The 3 cases of open injury who had underwent early repair of artery and nerve had various degrees of recovery of nerve functions and experienced no pain in the injured extremities. As for the 2 cases of blunt trauma, 1 got only pain relief and 1 had no recovery. Conclusion Dysfunction due to hematoma or progressive pseudoaneurysm compression on the brachial plexus can be relieved and patients can get maximal rehabilitation if hematoma or aneurysm is managed in time and the brachial plexus nerve is decompressed early.

Objective:To evaluate the efficacy of laparoscopic intrafascial hysterectomy.Methods:Thirty women underwent laparoscopic intrafascial hysterectomy(GroupⅠ),29 women underwent open intrafascial hysterectomy(GroupⅡ) and 30 underwent abdominal hysterectomy(Group Ⅲ) were compared.The operating time,blood loss,postoperative pain,postoperative morbidity,time to first flatus and emiction were analyzed.Results:The blood loss was in Group I(61.00?21.95)ml,respectively,it was significantly lower than those in the GroupⅡ(121.03?53.61)ml and Group Ⅲ(101.00?21.07) ml(P0.05).Conclusion:Laparoscopic intrafascial hysterectomy is truly a minimally invasive surgery,and was associated with significantly less intraoperative bleeding,shorter hospital stay with less morbidity and shorter convalescence period.This remains the obvious advantages of laparoscopic in comparison with abdominal hysterectomy.

Objective To investigate the current demand of expectations of family members of children in transfusion room. Methods By means of a self-designed questionnaire, the survey researched the demands of family members of children from 5 dimensions,the waiting time, transfusion environment, the quality of nursing,humanistic care and health education, and drug and safekeeping of security.The total 401 valid data were analyzed with descriptive statistics, chi square test, single factor variance analysis. Results No significant difference was found on their perception for the waiting time (χ2=1.051, P>0.05) and appropriate waiting time ( χ2=0.883, P>0.05). But there were significant differences between medical guarantee types and environmental needs (F=2.972, P<0.05 ), as well as between monthly income and the humanistic care and health education demand(F=2.566, P<0.05). Conclusion The expectation of respondents are diverse, changeable, showing high consistency for basic expectation,differences between different groups, discontinuity in different phase.

Four adults of Fasciola hepatica were found from the bile ducts of a patient diagnosed as biliary calculi during a surgi-cal operation. We investigated retrospectively the infection source and concluded that the patient may be infected by eating raw or half-cooked Zizania latifolia,an aquatic plant,which was contaminated with metacercariae of F. hepatica.

Objective To evaluate the therapeutic effect of traditional Chinese medicine and western medicine(TCM-WM) for the treatment of senile femoral neck fracture(SFNF) during perioperative period.Methods A retrospective analysis was carried out in 59 patients.Perioperative clinical data of SFNF patients admitted in orthopedics department of the second affiliated hospital,Guangzhou University of TCM were collected and analyzed.Postoperative complications,chief complaints,joint function and X-ray examination results were used to evaluate the effect of perioperative treatment.Results The patients received AO cannulated screw fixation,artificial femoral head replacement and total artificial hip joint replacement according to the classification of SFNF.Before theoperation,55 patients suffered from internal medical complications,in particular the cardiovascular diseases.After operation,one patient had dislocation of artificial hip joint and then died of deterioration of heart failure.Neither of the other patients suffered from infection of operative wound,vascular embolism of lower limbs,cerebrovascular accident,myocardial infarction,or pulmonary embolism.The 58 patients finally discharged successfully.Conclusion Active perioperative evaluation and treatment are the important measures to ensure the success of operation for the SFNF.

Based on melamine-Cu conjugate and subsequent interruption of formation of polythymine (Poly T)-templated copper nanoclusters (CuNCs), a novel fluorescent strategy was developed for detection of melamine.The method relied on the principle that the coordination of melamine to copper would be unfavorable for the reduction of Cu2+ in the poly T-CuNCs synthesis process, and thereby resulting in the decrease of fluorescence intensity of CuNCs.By this method, the fluorescence response of CuNCs displayed an linear relationship with melamine concentration in the range from 5 μmol/L to 120 μmol/L.The detection limit was 1.5 μmol/L.Furthermore, the assay was successfully applied in the detection of melamine in milk samples with good recoveries.

OBJECTIVE:To evaluate the effect of psychological intervention based on pharmaceutical care on the communi-ty patients with essential hypertension. METHODS:172 patients with essential hypertension in a community health service certer in Nanjing Gulou area in 2013 were divided into control group(n=87)and intervention group(n=85)by simple random meth-od. Control group received conventional antihypertensive drugs and management,intervention group additionally received pharma-ceutical care and psychological intervention,it lasted 6 months. Blood pressure controlling,drug compliance,mastery of drug knowledge and health status in 2 groups before and after treatment were compared. RESULTS:Before treatment,there were no significant differences in the systolic blood pressure(SBP)and diastolic blood pressure(DBP)between 2 groups(P>0.05);af-ter treatment, SBP and DBP in 2 groups were lower than before,SBP and DBP in intervention group were lower than control group,the decrease degree of SBP and DBP was bigger than control group,the differences were statistically significant (P<0.01). 1 month after the beginning of intervention,there was no significant difference in the proportion of drug compliance be-tween 2 groups (P>0.05);1 month after the end of the intervention,the proportion of drug compliance in intervention group was higher than 1 month after the beginning of intervention and control group,the differences were statistically significant(P<0.05). Before treatment,there was no significant difference in mastery of drug knowledge between 2 groups (P>0.05);after treatment,the proportion of patients showed good and excellent mastery of drug knowledge was higher than before and control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in scores of physical,mental,social health subscale and SRHMS between 2 groups(P>0.05);after treatment,scores of physical health subscale and SRHMS in control group,each subscale and to-tal scale scores in intervention group were higher than be-fore, and scores of mental, social health subscale and SRHMS in intervention group were higher than control group, the differences were statistically significant (P<0.05). CONCLUSIONS: The psychological intervention based on pharmaceutical care can effectively promote the con-trol of blood pressure,improve drug compliance,mastery of drug knowledge,health status and mental situation,which is worth of popularizing and applying in community health services.

Objective To summarize the clinical features of different racial patients with celiac disease (CD) and analyze the disease prevalence,diagnosis and treatment in Chinese population.Methods All the patients were diagnosed as CD and enrolled in Beijing United Family Hospital between January 2005 and July 2015.Clinical data including nationality,age,symptoms,endoscopic and pathological findings,outcome were collected and compared in patients from different countries.Results A total of 87 patients were enrolled including 63 Caucasians,18 Asian patients and 6 Middle East patients.The peak age of disease onset was 40-60 years old.Patients with typical symptoms such as chronic diarrhea and weight loss only accounted for 20.7％ (18/87) and 9.2％ (8/87) respectively.Some patients presented with nonspecific symptoms such as abdominal pain and bloating [32.2％ (28/87)],even constipation [5.7％ (5/87)].13.8％ (12/87) patients were previously diagnosed as irritable bowel syndrome.The incidence of abdominal pain,bloating,diarrhea and constipation between Asians and Caucasians had no statistical significance (P ＞ 0.05);but the proportions of weight loss,growth retardation,iron deficiency anemia and dermatitis herpetiformis in Asian group were significantly higher than that in Caucasian group (P ＜ 0.05).IgA type of anti-gliadin antibody (AGA),endomysium antibody (EMA) and tissue transglutaminase antibody (tTGA) were dominant autoimmune antibodies in patients with CD,which accounted for 58.6％ (51/87),44.8％ (39/87) and 36.8％ (32/87) respectively.The endoscopy showed that the lesion of CD was mainly located in small intestine,with reducing severity from the proximal to the distal small intestine.The lesions of duodenal bulb and descending duodenum appeared more significant in Asian group.Accordingly pathological intestinal atrophy and the degree of intraepithelial lymphocytosis were more severe in Asian patients.All 87 cases took the gluten-free diet (GFD).Eighty-one cases received serological follow up and 8 with endoscopic intestinal biopsy.The celiac disease antibodies in 47 patients turned negative from 6-9 months after GFD treatment,while 34 patients turned negative from 12-18 months after GFD.All patients reported disease remission to some extent.After 1 year GFD treatment,the pathology of endoscopic intestinal biopsy in 8 patients showed significant improvement of villous atrophy and lymphocyte infiltration.Conclusions CD patients with typical clinical manifestations are not the majority.Serological celiac disease antibodies (AGA,EMA and tTGA) have a high diagnostic value.GFD treatment is effective on majority of celiac patients.Clinical manifestations,endoscopy,intestinal pathology,and response to GFD in Chinese patients are not the same as Caucasians.Clinicians need to pay attention to the differential diagnosis.

Objective To assess pathological features of muscles as well as microvascular changes between muscle fibers in patients with dermatomyositis (DM),and to analyze pathological differences in muscles between DM and polymyositis (PM).Methods Specimens were obtained from involved muscles of 16 patients with DM,5 patients with PM,and from normal muscles of 9 patients with bone trauma (controls).Routine histopathological examination and immunohistochemical staining for CD34 and CD61 were conducted.Results Of the 16 patients with DM,6 (37.5％) had perifascicular atrophy,3 ( 18.8 ％) had an obvious inflammatory cell infiltration around microvessels between muscle fibers.Perifascicular atrophy was absent in muscle specimens from patients with PM or bone trauma.The number of CD34-positive microvessels between muscle fibers was reduced in patients with DM,but normal in those with PM.CD61 was positive in perifascicular area of 10 patients (5 moderately positive and 5 weakly positive) with DM,with an expression rate of 62.5％,however,only 1 case of PM was weakly positive for CD61,and all the controls were negative.Conclusions There is a decrease in the number of microvessels but an enhancement of neovascularization between muscle fibers in involved muscles of patients with DM,which may serve as a pathological marker to distinguish DM from PM.

ObjectiveTo investigate the localization G protein couple receptor 30 (GPR30) and its mRNA in submaxillary gland, and to supply theoretic evidence for further studying functional significance of the GPR30 in submaxillary gland of rats. Methods Four male SD rats were sacrificed by cervical dislocation after the intraperitoneal anesthesia, and excised the submaxillary glands. The distribution of GPR30 and its mRNA were studied through immunohistochemistry and in situ hybridization in the experiment. After isolation of the total RNA from the submaxillary gland, RT-PCR was conducted to obtain GPR30 cDNA by using the specific primers. The products of PCR were analyzed by sequencing with Sanger's method. Results The serous acinus epithelial cells and granular convoluted epithelial cells in submaxillary gland of rats showed GPR30 immunoreactivity, which were located in cytoplasm with negative nuclei. GPR30 mRNA hybridized signals were also detected in cytoplasm in the above cells. The products of PCR is identical to that of the GPR30 sequence of rats. Conclusion The serous acinus and granular convoluted epithelial cells not only express GPR30 but also may be a target organ by rapid estrogen signaling pathway in submaxillary gland of rats. This may be involved in the functional regulation of submaxillary gland.