Objective To determine the best time to operate on elderly patients with acute severe cholangitis (ACST).Method The time to operate was analysed in 36 elderly patients with ACST.Result With active preoperative anti-shock treatment,the mortality rates for emergency surgery within and after 8 hours were 8.3％ and 33.3％,respectively.Conclusion Early operation for elderly patients with ACST markedly reduced mortality.

This article deals with the rehabilitative technology speciality launched in polytechnic,discusses its education orientation and cultivation pattern,explores the cultivation rule of professionals of rehabilitative technology and gives some beneficial complementarities for the cultivation of professionals of rehabilitative technology.

Natural products were the material basis of drug discovery and drug screening, and high-performance techniques were the important prerequisite of earning hits. In this paper, we reviewed the current situation and future prospects of drug screening, including the pharmaceutical environment, the challenges facing drug discovery, the screening tools and the methods of generating analogs.

Objective To summarize the experience in the management of incarcerated umbilical hernia in cirrhotic patients with aseites. Methods The operative methods, perioperative management and fellow-up data of 15 patients diagnosed incarcerated umbilical hernia in the setting of cirrhosis and ascites were studied retrospectively. All the patients underwent emergency operation to remove necrotic umbilical skin and hernial content, including incarcerated greater omentum (6 cases) and strangulated segment of small bowel (5 cases). After debriding the operating field thoroughly, the umbilical hernia was repaired with polypropylene mesh, among those Sublay repair was used in 11 cases with the longest diameter of hernial ring more than 3 cm and Onlay repair in 4 cases with the longest diameter of hernial ring less than 3 cm. During the perioperative period, albumin and fresh frozen plasma transfusion, as well as diuresis and ascites paracentesis, was adopted to treat eirrhosis and ascites. Results All the patients underwent operation successfully. The operative time was 90～185 min, averaging at 122 min. Seroma formation in 2 cases and incision infection in one were cured with conservative therapy. One patient died of multiple organ dysfunction after the operation. During the fellow-up of 1～5 years, 1 patient died of liver function failure and there was no hernia recurrence. Conclusion With appropriate perioperative management and correct operative method, polypropylene mesh could be adopted in the emergency repair operation of incarerated umbilical hernia in the setting of cirrhosis and ascites.

Objective To assess quantitatively the association between smoking and the risk of disease and death from pulmonary tuberculosis(TB) by a meta-analysis. Methods Both Chinese and English literatures published from Jan. 1999 to Jun. 2010 about the case-control study of the association between smoking and pulmonary TB were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a software RevMan 4.2. Finally,possible publication bias was tested and a sensitivity analysis was conducted. Results The meta-analysis for total 22 high-quality case-control studies found a pooled OR of 2.56 (95% CI 1. 80 ～3.64) with a random-effects model. Sensitivity analysis showed that pooled OR was 2.56 (95% 1.76 ～3.71 ) by removing two papers of nested case-control study. The OR were 2.13 (95% CI1.76～2.58) and 4.60 (95% CI 1.81～11.69) for disease and death from TB,respectively. After confounding factors,including age and gender,had been controlled the OR was 2.53 (95% CI 1.27 ～5.03 ) whereas 1. 99(95% CI 1.54 ～ 2.56 ) without control of them. Conclusion Smoking can increase the risk of incidence and death of TB. TB control programs and treatment of patients might benefit from interventions aimed at reducing tobacco exposure.

In this article , the hot ethical concerns related to totally endoscopic thyroidectomy have been ana-lyzed and discussed .The author considers that this procedure is consisted with the patient′s no-harm and advanta-geous ethical principles , and the patient′s privacy is well protected .However , different procedures and operative risks should be well understood by the patients before the operation .Patient′s independence should be respected .

Objective To study Dendrobium from Yunnan Province by Fourier transform infrared spectroscopy (FTIR) combined with hierarchical cluster analysis.Methods Stems of 83 trees from 11 Dendrobium varieties were tested through using FTIR, so as to analyze the differences among different varieties and identify Dendrobium variety by second-derivative spectral, the correlation analysis and hierarchical cluster analysis.Results The spectra showed that the main ingredients of stems were cellulose, lignin and polysaccharides. The fraction of lignin and cellulose ofD.officinate was lower, while that for polysaccharides was higher. There was a high correlation among spectra, with the correlation coefficients of more than 0.980, and that for second-derivative spectral was 0.751 to 0.980. All the samples were clustered by second-derivative spectral, with the correct rate of 87.9%. Hierarchical cluster analysis showed that the components ofD.hercoglossum, D.lohohense andD.adumcum,D.brymerianum andD.nobile,D.guangxiense andD.fimbriatum are more similar than that of others.Conclusion FTIR combined with hierarchical cluster analysis can distinguish and identify different varieties of Dendrobium, and is an effective and simple way to identify different varieties.

Objective: Using the implicit association test to examine the implicit attitude-difference of Chinese students towards their father and mother.Methods: The experiment followed the standard paradigm of IAT.77 college students(43 women,34 men) participated the research.Results: The results indicated that there were implicit attitude-differences held by Chinese students towards their father and mother.Besides,gender dissociation existed.Conclusion: There is implicit attitude-difference in Chinese students towards their father and mother.

Objective To investigate and summarize preliminarily the clinical experiences of laparoscopic incisional hernia repair with intraperitoneal patch placement for the patients over 70 years old.Methods From July 2005 to July 2008,laparoscopic incisional hernia repair with intraperitoneal onlay meshes were applied in 8 patients,and whose clinical data were studied retrospectively.Results The procedures were performed successfully in all patients except one converted to open because of severe adhesion.The mean operative time was 105 min(ranged from 50 min to 180 min).One postoperative hypercapnia was resolved through mechanic ventilation for 24 h.One seroma and 1 prolonged postoperative pain over 1 month occurred,which were cured with conservative therapy.Mean postoperative hospital stay was 9.5 d(ranged from 7 d to 14 d).There was no recurrence or local discomfort during 12-36 months(average 26.5 months)follow-up.Conclusions Laparoscopic incisional hernia repair with intraperitoneal onlay mesh for the patients over 70 years old is safe and feasible,which has some advantages such as less trauma and rapid recovery.The perioperative management and operative technique are very important for the success of operation.

Objective: To establish an HPLC method for determination of chlorogenic acid, baicalin, emodin and chrysophanol contents in Kangjunxiaoyan tablet. Methods: After removing the coating, the powder of Kangjunxiaoyan tablet was extracted by 50% methanol for 30 min using the following condition: analytical column, Agilent Eclipse Plus-C18 column (4.6 mmX250 mm, 5 μm); mobile phase: A, 0.1% (v/v) phosphoric acid-water, B, methanol, C, acetonitrile with gradient elution. The flow rate was 0.8 ml/min; the detection wavelength was set at 254 nm; the temperature of column was 30°C; and the injection volume was 10 μl. Results: The title compounds were separated at baseline within 45 min with good linear, with the regression being Y = 12.89X-12.66, r = 0.9999 for chlorogenic acid, Y = 13.96X-1.013, r=1.0000 for baicalin, Y=35.82X-4.923, r=0.9999 for emodin, and Y=44.16X-3.280, r=0.9999 for chrysophanol. The intra-day and inter-day precisions and the limits of detection were all within the normal range. The recovery rates (n=3) were: chlorogenic acid 101.5% (RSD=1.6%), baicalin 103.4% (RSD=1.4%), emodin 99.3% (RSD=2.0%), and chrysophanol 98.1% (RSD=1.7%). Conclusion: HPLC is a simple, accurate, stable, and reliable method in determining the contents of chlorogenic acid, baicalin, emodin, and chrysophanol in Kangjunxiaoyan tablet, and it can be used for quality control of this preparation.