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 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.

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.

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.

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 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 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.

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 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.