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.

Objective To investigate the application effects of milk protein challenge test and serum specific IgE antibody de-tection in children with milk protein allergic diseases.Methods 76 cases of children with milk protein allergic diseases of North Hospital of the People’s Hospital in Urumqi City from January,2013 to December,2015 were treated with milk pro-tein challenge test.The clinical characteristics,results of milk protein challenge test and serum IgE antibody detection,and the value change of routine blood indexes were analysed and compared.Results Diarrhea and hematochezia were the most common clinical features,vomiting,hematemesis and abdominal distention were rare.47 cases (61.8%)showed positive re-sults in milk protein challenge test,and 29 cases (38.2%)showed negative results.42 cases of positive children had delayed allergy,and 5 cases showed rapid allergy.Compared with the negative group,the positive rate of serum specific IgE antibody in positive group didn’t change obviously,the difference was not statistically significant (14.9% vs 6.9%,χ2=0.466,P>0.05).The neutrophil count in positive group was higher after challenge than that of before challenge (t=2.480,P<0.05). The number change of blood cell,neutrophil and platelet in positive group were no statistical differences compared with those in negative group (t=0.500,1.395,0.296,all P>0.05).Conclusion Diarrhea and hematochezia were the most commom disease of digestive tract in children with milk protein allergic diseases.It is necessary to perform milk protein challenge test in clinical practice,however,serum specific IgE antibody is not considered as its diangnosis basis.

Vaccination in children suffering neurological diseases is a troublesome issue that people es-pecially pediatricians are reluctant to mention. Due to worrying about the emergence of adverse reactions and concerning on the heat induced seizure,doctors and parents tend to cancel or do not recommend these children to be vaccinated. Additionally,the heat sensitive seizures,such as febrile seizure( FS) ,generalized epilepsy with fe-brile seizure plus(GEFS+),Dravet syndrome account for the largest proportion of the seizure related disease and epilepsy syndrome. Their pathogenesis has been proved relating to the mutation of SCN gene of the sodium channel. For children with FS,GEFS+,and Dravet syndrome,vaccination may lead to fever,which even may bring about convulsions,but it will not result in worse prognosis.

ObjectiveTo compare the efficacy between needling peri-ocular points plus abducens oculi and needling peri-ocular points alone in treating abducens paralysis, for evaluating the effectiveness and advantage of needling peri-ocular points plus abducens oculi.MethodFollowing the random number table, 86 patients with postnatal unilateral abducens oculi were divided into two groups: 43 cases in the control group were intervened by conventional acupuncture at peri-ocular points including bilateral Taiyang (EX-HN5), Cuanzhu (BL2), Fengchi (GB20), Hegu (LI4) and Waiguan (TE5), plus Baihui (GV20), Sizhukong (TE23) and Tongziliao (GB1) on the affected side; 43 cases in the treatment group were intervened by acupuncture at peri-ocular points and abducens oculi, i.e. to puncture the abducens oculi (1~3 mm behind the attached point of the extrarectus to eyeball) in addition to the treatment given to the control group. After 3 treatment courses, the total effective rate, average recovery time and improvement of strabismus angle were observed.ResultThe total effective rate was 93.0% in the treatment group, significantly higher than 81.4%in the control group (P<0.05); of the 28 cured patients in the treatment group, the average recovery time was (34.51±7.91)d, versus (41.88±7.87)d in the 22cured patients in the control group, and the difference was statistically significant (P<0.01). There was a significant difference in comparing the improvement of strabismus angle between the two groups (P<0.01); after treatment, the strabismus angle was (11.23±6.32)° in the treatment group versus (14.14±6.85)° in the control group, and the difference was statistically significant (P<0.05).ConclusionNeedling peri-ocular points and abducens oculi can improve the strabismus angle, shorten treatment duration and reduce patient’s sufferings in treating postnatal abducens paralysis, significantly superior to conventional acupuncture at peri-ocular points.

Objective To investigate the influence factors of cognitive impairment in epilepsy children with less than 6 years old. Methods Eighty-nine epilepsy children with less than 6 years old were selected. The neuropsychological detection was tested by Gesell developmental diagnostic scale (GDDS), and head imaging examination (CT or MRI) and ambulatory electroencephalogram (EGG) were checked. Results The scores of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal- social behavior were (82.98 ± 14.02), (85.86 ± 13.79), (83.14 ± 13.44), (84.75 ± 3.29) and (84.99 ± 14.37) scores, the average development quotient of the children with epilepsy were greater than 75 scores, and there were no statistical differences among them (P > 0.05). According to the test results of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal-social behavior, the rates of developmental delay children were 21.35% (19/89), 19.10% (17/89), 16.85% (15/89), 24.72% (22/89) and 22.47% (20/89), and the rates of moderate to severe developmental delay were 3.37% (3/89), 3.37% (3/89), 4.49% (4/89), 3.37% (3/89) and 3.37%(3/89). Multivariate analysis results showed that first onset age of epilepsy and head imaging performance were correlated with adaptive behavior, big sports behavior, fine motor behavior and personal-social behavior (P < 0.05). Conclusions The first onset age of epilepsy and head imaging performances are the major factors in cognitive performance in epilepsy children with less than 6 years old, so clinical attention should be paid to improve the prognosis of cognitive outcome of epilepsy children, and improve their life quality.

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 .

Based on the health service delivery system and its performance, it shows the major issues faced by Indonesian health system, including heavy disease burden of NCD, imbalance allocation of medical care and resources, poor access to health service in rural area, low level of government health budget and so on. Presently, the reform in Indonesian health system is in the direction of equity and self-government, via participation of community, private sector or civil society, availability of comprehensive, equitable health care and health resource, to enhance health system and improve population health.

tumours was found to be slightly faster than those of the controls.Conclusion:Hes1 is overexpressed in colon cancer than that in normal tissue, and Hes1 is upregulated in poorly differentiated cancer samples compared with well-differentiated tumour samples. Hes1 has a positive inlfuence on the ability of tumour-formation in SW620 cellsin vivo.

Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.