Objective To study features and causes of biliary duct re-operations and evaluate their therapeutic efficacy for avoiding its occurrence and decreasing its number.Methods 32cases of the clinical data of all de patients receiving bile duct re-operations in our hospital from 1996 were retrospectively analyed.Results 32 cases have no surgical operation complications,with 23 cases visit 5 years and only 2 cases are poor.Conclusions The main cause for re-operations is bile ston.The purpose of re-operations is to clean up stones,correct strictures and build pathway for bile flow.

Objective:To investigate the prevalence of cervical infection with high-risk human papillomavirus (hr-HPV) among the rural women of Jing-an County in Jiangxi Province. Methods:A population-based cross-sectional study was conducted among rural women of ages 35 years to 59 years in Jing-an County between May 2012 and November 2012. A total of 4 673 women were enrolled. Hybrid capture2 (hc2) was detected in 2 491 women, whereas HybriMax was detected in 2 182 women to understand the different hr-HPV types. Results:The overall hr-HPV prevalence was 11.9%. Multiple-type infections accounted for 41.5%. The most commonly seen hr-HPV type was HPV52 (2.8%), followed by HPV58, HPV16, and HPV39. No significant difference was observed in the preva-lence of hr-HPV infection between women in the mountainous and the plain areas in Jing-an County. However, the age distribution of HPV infection significantly differed (P<0.001). Conclusion:Hr-HPV infection rate in Jing-an County was close to that of other areas in China. HPV52 and HPV58 appeared to be the most prevalent HPV types and should be employed as a basis for HPV prevention in this area.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

Objective To study the effects of the inhibition of nuclear factor kappa-B ( NF-κB) , on the hepatic heat shock protein 70 (HSP70) expression as well as on the changes of hepatic function and ultrastructure in a rodent model of hemonhageic shock. Method Hemorrhagic shock was produced by inducing bilateral femoral fractures in male Wistar rats. Intraperitoneal injection of pyrrolidine dithiocarbamate(PDTC)was used to inhibit NF-κB activation 1 hour before induction of shock. A total of 66 adult male Wistar rats were randomly divided into 3 groups: control group (Control, n = 6), trauma shock (TS, n = 30), and NF-κB inhibition followed by trauma shock (NF-κB inhibition, n =30). Measurements of hepatic NF-KB and HSP70, hepatic function bio-markers, TNF-α and IL-6 were obtained 0.5, 2, 4, 6, 8 hours after trauma. Histopathological changes in liver tissues were also noted. Hepatic expression of NF-κB was determined by using electrophoretic mobility shift assay, while HSP70 was assayed by western blot and analyzed with computer imaging. Results In rats with trauma shock, both hepatic NF-κB activity and HSP70 expression increased significantly compared to the control group, reaching peaks at 6 hour post injury. Serum alanine transferase (ALT) and total bilirubin (TB) also rose significantly,reaching peaks at 8 hours post trauma. Light microscopy revealed hepatic congestion with infiltration of inflammatory cells into hepatic sinusoid in the TS group at 8 hours. Inhibiting the activity of NF-κB one hour before trauma significantly decreased expression of HSP70 at 6 hours post trauma [16.9±4.4 (NF-κB inhibition) vs. 23.0±1.7 (TS), P ＜ 0.05]. In addition,levels TNF-α and IL-6 in the liver tissue also decreased, and hepatic congestion as well as hepatic cell degeneration were ameliorated, showing minimal inflammatory infiltrates in the hepatic sinusoids. NF-κB inhibition also significantly lowered the levels of ALT and TB at 4 hours post trauma [ALT, 540.8 ±66.2 nmol/L (NF-KB inhibition) vs. 640.6±80.2 nmol/L (TS), P ＜ 0.05; TB,2.3±0.3 mol/L (NF-κB inhibition) vs. 4.7 ±1.1 mol/L (TS), P ＜ 0.05]. Conclusions NF-κB and HSP70 are involved in the pathogenesis of hepatic injury during hemorrhagic shock, and the degree of NF-κB activity and HSP70 expression may be consistent with the extent of hepatocellular damage. Inhibition of NF-κB helps ameliorate liver injury due to trauma shock.

Objective To investigate the risk factors of early postoperative complications in patients undergoing pancreaticoduodenectomy. MethodsClinical data of 200 patients undergoing pancreaticoduodenectomy in our hospital from December 1999 to September 2002 were collected and analyzed retrospectively. Nine clinical factors were recruited for the study in relation to surgical complications. ResultsThe overall early postoperative complication rate was 21% (42/200). Logistic regression analysis revealed that no T tube drainage(OR=10.015), preoperative total serum bilirubin level over 171.1?mol/L(OR=7.756), preoperative diabetes (OR=4.086), end-to-end pancreaticojejunostomy (OR=2.616), intraoperative blood transfusion over 1000 ml (OR=2.410), over 65 years old (OR=2.162) were important factors for early complications. ConclusionsT tube drainage, end-to-side mucosa-to-mucosa pancreaticojejunostomy and good surgical expertise can decrease early morbidity rate.

AIM: To investigate the functions of GR in the course of hepatic secondary injury after severe multiple injury. METHODS: Rat model was produced by adopting severe thoracic impact injury accompanied with mono-side femur fracture, and glucocorticoid receptor was blocked before severe multiple injury. Hepatic macropathology and alterations under light microscope were examined. Maximal binding volume of glucocorticoid receptor (GR) in hepatic tissue was assayed by radio-ligand binding assay and protein content was assayed by Western blot. RESULTS: Maximal binding volume and protein content of GR were gradually decreased in hepatic tissue after severe multiple injury, obviously lower than that in normal control at 4 h after trauma ( P

Objective:To retrieve, evaluate and summarize the relevant evidence for respiratory management in patients with amyotrophic lateral sclerosis (ALS), and provide reference for clinical nursing.Methods:The best practices, guidelines, expert consensus and other evidence on respiratory management in ALS patients were systematically retrieved from dometic and foreign relevant guide websites, professional associations and databases. The retrieve period was from January 1, 2016 to April 15, 2023. After the literature quality evaluation, the evidence was extracted from the literature that meets the quality standards.Results:A total of 12 references were included, including 3 guidelines, 1 expert consensus, 1 evidence summary, 4 systematic reviews, and 3 randomized controlled trails. The 25 pieces of evidence were summarized from the patients with ALS, including respiratory assessment, mechanical ventilation, secreta management, and respiratory rehabilitation.Conclusions:This study summarizes the best evidence on respiratory tract management in patients with ALS, which is convenient for clinical medical personnel to carry out more targeted and scientific respiratory assessment, intervention and guidance for patients with ALS.

Objective To investigate current research in nursing interventions for shoulder-hand syndrome after stroke in Class Ⅲ Grade A hospitals in China.Methods Totally 215 nurses from the departments of neurology and rehabilitation of 6 Class Ⅲ Grade A hospitals from a municipality or provincial capital from 6 provinces,which scattered across the northern,northeastern,eastern,central and southern,southwestern and northwestern parts of China,were selected by convenient sampling between January and June 2016.The nurses were investigated with the self-designed Shoulder-hand Syndrome After Stroke Questionnaire.Totally 215 questionnaires were sent out,with 184 valid questionnaires collected.SPSS 21.0 software was used in data statistics.Results The 184 nurses' average scores in the dimension of attention to shoulder-hand syndrome after stroke was(4.38±0.59);and the score in reasonableness of nursing interventions for shoulder-hand syndrome after stroke was(3.98±0.88).Their scores in nursing knowledge related to patients with shoulder-hand syndrome was(48.50±16.67),and their scores in the dimensions in clinical manifestation,risk factors and interventions were(4.59±3.24),(2.67±3.90)and(4.06±1.21),respectively.The knowledge scores were sorted in descending order,and the top 3 scores were found in"nursing principles for shoulder-hand syndrome" "best period of rehabilitation training for shoulder-hand syndrome" and "observation points of affected extremities".Conclusions The nurses' attention to and knowledge about shoulder-hand syndrome after stroke is not enough.There is a lack of standards or guidelines for shoulder-hand syndrome.The process of nursing interventions for shoulder-hand syndrome is not reasonableenough and the nursing processes are not fully implemented.Therefore,nursing processes need to be further standardized.

Objective? To compare the predictive power of Padua Scale and Wells Scale on stroke complicated with deep venous thrombosis (DVT). Methods? Totally 300 patients with stroke admitted in the Department of Neurology, Peking University Third Hospital from November 2016 to November 2017 were selected by convenient sampling and investigated with Padua Scale and Wells Scale. The incidence of DVT was determined according to color Doppler ultrasonography for deep veins. The predictive power of the two scales on stroke complicated with DVT was evaluated; and the Receiver Operating Characteristic (ROC) model was established to compare the sensitivity, specificity and area under the ROC (AUC). The positive and negative predictive values of the two scales were calculated. Results? Both scales could predict the risks of stroke complicated with DVT (P＜0.01). The AUC of Padua Scale and Wells Scale was 0.802 (95%CI=0.704-0.900) and 0.746 (95%CI=0.642-0.851). The sensitivity of Padua Scale and Wells Scale at the best cutoff value was 80.00% and 64.00%, and their specificity was 58.18% and 77.82%. Their positive predictive values were 14.81% and 20.78%, and their negative predictive values were 96.96% and 95.96%. Conclusions? Padua Scale is more suitable for predicting the risk of DVT in lower extremities of patients with stroke.

Objective To explore clinical features and prognosis of patients with hereditary nonpolypnsis colorectal cancer(HNPCC).Methods Twenty-four kindreds of Chinese HNPCC according to Amsterdam standard were enrolled and their pedigree trees were drawn.Clinicopathological and follow- up data were collected,clinical features and prognosis of 24 kindreds of Chinese HNPCC were analyzed as well.Results Among 24 H NPCCkindreds,there were 116 cases of cancer including 16 cases of multiple cancers in probands and 9 cases of multiple cancers in the members of kindreds.The age of patients ranged from 19 to 74.Of all the patients,there were 120 loci of colorectal cancers and 32 foci of HNPCC related extracolonic cancers.Among probands of 24 HNPCC kindreds,the average incidence age of onset- ring first colorectal cancer was 42.5,the male and right-side colon cancer patiens were more than female and left-side colon cancer patiens,respectively.The most pathologic type was tubular adenocarcinomas with moderately differentiation,which accounted for 45.8%(11/24).Up to the deadline of follow-up, 14 cases had survived for more than 5 years accounting for 58.3%(14/24) Of them,9 cases survived for more than 10 years and 1 case survived for 27 years.Conclusions Chinese patients with HNPCC have special characteristics such as moderately differentiated tubular adenocarcinomas,early onset of coloreetal cancer,right-side colon involvement.