Orthodox Manual of External Diseases is a book giving an exhaustive description on various kinds of external and surgical disease,written by CHEN Shi-gong(1617),the author pay more attention to concept of wholism and syndrome differentiation.He provided the original view on the treatment of disease that combine internal with external therapy,needle with herbs.① All the external symptoms originates from internal causes and all diseases arisen from pathogenetic fire.Carbuncle definitely caused by visceral disorders,addiction to greasy diet,overstrain and exhaustion of sexual activities.② Based on occurrence and development of surgical disease,currency of ebb and flow between pathogenic factors and health qi,he provided three therapeutic methods for surgical disease including resolving,expelling from within,and reinforcing.③ He created and improved some surgical operation and provide the new therapeutic way that expelling the pathogenic factor by opening and drainage.④ He also believed that invigorating and regulating spleen and stomach,harmonizing qi and blood should be put in the first place when treating disease.

Hepatitis A is one of the global public health problems,and China has high prevalence. In order to decrease the incidence of hepatitis A,China has integrated Hepatitis A vaccine into Expanded Program on Immunization (EPI) in 2007. The paper will provide some ideas on the immunogenicity and impact factors of the different types of hepatitis A vaccines that are used in China.

The pancreatic polypeptide (PP) cells of rat pancreatic islets were demonstrated by immunocytochemical method. The distribution and morphology of PP cells were investigated in order to observe their changes during postnatal development. At the lst day and 7th day of rat after birth, the PP cells of islets were different from that in adult, the processes of PP cells were not evident, and the immunoreactivity was weaker. In addition, the PP cells were also presented in the duodenum epithtlium. After 18th day, the distribution and morphology of the PP cells did not show obvious difference from that in adult. The percentage of PP cells of islets was less in lst day, and approximated to adult level in 18th day, and over adult level in 28 th day. The above changes of percentage of the PP cells showed mainly in islets in the head of pancreas. The changes of volume density and numerical density per area corresponded with the changes of percentage of the PP cells. Immunoelectron microscopic study showed that the secretory granules (SGs) and gold la belled particles on the SGs of the PP cells in 7th day were less than that in 28th day and adult. Based upon the morphology of the SGs, the PP cells can be classified into two types. The type Ⅰ cells contained SGs with medium electron density or empty-like cores, and larger SGs were more. The type Ⅱ cells contained SGs with lower electron density cores, and small SGs were more. The gold labelled particles in SGs in the type Ⅰ were more than that in the type Ⅱ. The results suggest that the PP cells of rat islets continue to change after birth.

Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Objective To explore the relative factors on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and the signifiance of P 300 for judging the severity and prognosis of DEACMP.Methods Thirteen aspects such as contact time with carbon monoxide (CO)?coma time et al were analysed between 44 patients with DEACMP (DEACMP group)and 42 patients with acute CO poisoning but without DEACMP (ACMP group). P 300 s were studied in the patients with P 300 as compared with the patients had just caught acute CO poisoning (DEACMP group).and 44 normal controls (NC group).Results There was extremely significant difference in contact time with CO,coma lasting time,treatment time with hyperbaric oxygen,age,complication ( P

Objective To evaluate the efficacy of emergency transcatheter arterial embolization(TAE)for spontaneous rupture of hepatocellular carcinoma(HCC).Methods We retrospectively reviewed 16 cases of spontaneous ruptured HCC which had been treated in our hospital between 1997 and 2005.Emergency TAE was performed in the 16 patients,with 6 cases complicated by hypovolemic.Results Bleeding from the ruptured HCC was stopped at the end of the procedure in 16 patients who had undergone successful embolization.The time from the onset of clinical symprtom to TAE been completed was 1.5-5 hours(mean,3.6 hours),The shortest time was 1.5 hours in 3 patients.Following the achievement of hemostasis by TAE,transcatheter arterial chemoembolization(TACE)2-6 times for each case with average 3.7 and CT guided percutaneous ethanol injection(CT-PEI)5-9 times for every case with arerage 6.8 were performed in 12 cases.3 cases were given up for further treatment.The liver transplantation was carried out in 1 case 3 days after TAE.The average survival time was 14.3 months.Conclusions Emergency TAE is safe and effective for bleeding due to spontaneous rupture in HCC and would achieve better result by adding TACE and CT-PEI.Liver transplantation is one of the options for the patients with poor liver function.The combination of all methods above can prolong patients survival time.(J Intervent Radiol,2006,15:228-231)

Along with the progressing of micro-electronics technology and the improving of FPGA's performance, it's more and more common to process digital signals using FPGA. In most cases, FPGA is used to do the preprocessing or postprocessing besides processor in order to get a higher processing speed. This article introduces how to construct the signal processing unit of Doppler measurement system with FPGA and universal digital signal processor.

As the important content of excellent quality nursing service, the performance appraisal of nursing staff was closely interrelated to their income distribution, professional title promotion and excellence choosing. Performance appraisal was the requisite part of nursing resource management. This study gave an overview about conception and development of nursing staff′s performance appraisal and summarize key performance indicator,balanced score card,SMART principle and 360 degrees performance appraisal, which was mainly used in domestic hospital. It suggested nursing manager should have complementary advantages of them and utilize foreign mature methods to explore and improve our countries performance appraisal of nursing staff and formulate the system which was in keeping with China′s national conditions.

Purpose There is no agreement for contrast enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant thyroid nodules. This paper aims to evaluate the diagnostic value of the conventional and contrast-enhanced ultrasonography in the diagnosis of thyroid nodule by meta analysis. Materials and Methods Literature search was performed in PubMed, CNKI and Wanfang databases to identify relevant English and Chinese literatures by using pathological results as the gold standard from January 1990 to September 2014. The quality of each selected study was evaluated by QUADAS. The pooled weighted sensitivity, specificity and the corresponding 95% CI were calculated. Summary receiver operating characteristic curves (SROC), area under curve (AUC) and the Q* index were also calculated. Results A total of 14 literatures (1970 nodules) were included, the pooled weighted sensitivity and specificity of conventional ultrasonography were 0.74 and 0.70; those of contrast-enhanced ultrasonography were 0.86 and 0.82. The AUC by using the two methods were 0.84 and 0.93, respectively, and the Q* index were 0.77 and 0.86, respectively. Conclusion In the diagnosis of thyroid nodule, the accuracy of contrast-enhanced ultrasonography is better than conventional ultrasound; however, both of them have high clinical value in the diagnosis of thyroid nodule, thus they are helpful in avoidance of unnecessary surgical treatment in patients with thyroid disease.