This paper summarizes the observation and nursing of patients with postoperative complications following percuta-neous transhepatic cholangogrphic drainage(PTCD) and biliary tract stent implantation for malignant obstructive jaundice. A-mong thirty-two patients,eight had postoperative complications,including two with biliary tract hemorrhage,four with biliary tract infection,one with pneumothorax and one with bile leakage. All the thirty-two patients recovered well in clinical symptoms and quality of life. To attach importance to psychological nursing and postoperative health education are the key points in nursing care of patients with PTCD,which play important roles in alleviating clinical symptoms,improving treatment outcome and pro-moting the patients' quality of life.

BACKGROUND: Research has proved that nifedipine can improve the functions of vascular endothelial cells. However, it still needs further study on its mechanism on dilating vessels.OBJECTIVE: To observe the effects of controlled-release nifedipine to nitrogen monoxide(NO) and induced nitric oxide synthase(iNOS) in spontaneously hypertensive rats(SHR).DESIGN: Comparative observational study based on experimental animals.SETTING: Experimental animal centre in a medical college.MATERIALS: This study was completed in Experimental Animal Centre of Shandong University during April to May 2002. Twenty-one recombinant inbred rats of clean class with body mass of(300 ± 2) grams were provided by Experimental Animal Centre of Shandong University. They were randomly divided into three groups: control group, normal group and low dose group,each with 7 rats.METHODS: Saline(10 mL/kg), 10 mL/kg and 3 mL/kg controlled-release nifedipine solution(0. 3 g/L) were poured into stomach to rats in control group, normal dose group and low dose group once everyday for 15 days respectively. Eyeball was removed to collect blood and heart and lung were removed at the same time to test the content of NO and iNOS in serum after last administration.MAIN OUTCOME MEASURES: Content of NO, comparison of iNOS activity between groups.RESULTS: There was significant difference on NO content between normal dose group and control group, low dose group after 15 days' administration ( P < 0. 01 ) . Compared with control group and low dose group, there was significant difference on the iNOS activity in heart and lung of normal dose group(P <0.01, P <0.05).CONCLUSION: While nifedipine reduces the blood pressure, it can also improve the content of NO and resist the increasing activity of iNOS casued by increased blood pressure.

Objective To observe the clinical efficacy of acupuncture with elongate needle plus red light radiation in treating post-herpetic neuralgia.Method Seventy patients with post-herpetic neuralgia were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by acupuncture with elongate needle plus red light radiation, while the control group was by orally taking Pregabalin capsules. Visual Analogue Scale (VAS) and Quality of Life (QOL) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 97.1% in the treatment group, versus 71.4% in the control group, and the difference was statistically significant (P<0.05). After treatment, VAS and QOL scores were significantly changed in both groups (P<0.05). The VAS and QOL scores in the treatment group were significantly different from that in the control group after treatment (P<0.05).Conclusion Acupuncture with elongate needle plus red light radiation is effective in relieving post-herpetic neuralgia.

Objective To develop a new method with using surgical procedures for multiple correction of nasal deformity with cleft lip and palate.Methods Our operation procedures included elevation of the nasal floor depression in cleft side with the transplantation of autogenous cancellous bone, frustration and elevation of the nasal bone and part of the frontal process of maxilla, and replacement of septum between alar cartilages.Through these procedures, the nasal deformity could be multiply corrected.Results Postoperative follow up for 1～8years in 45 patients demonstrated satisfactory results. Conclusion Multiple correction is a new method of treatment for nasal deformity with cleft lip and palate.

Objective To investigate the different clinical behavior and the diagnosis and trearment of primary hyperparathyroidism(PHPT). Methods Clinical data of 53 patients with PHPT treated in Beijing Jishuitan Hospital from May 1977 to April 2004 were collected and analyzed. Results 53 patients with PHPT were confirmed by operation and pathology. The majority of the patients were aged 20~50 years. There were more female than male patients. There were various clinical manifestations, and the duration of illness was (protracted). Many cases were misdiagnosed. There were bone pathologic changes of varying extent in all (patients), stones in urinary system plus bone pathology in 11 cases, serum level of calcium was raised in 51 patients(96.2%) and (parathyroid) hormone (PTH) was elevated in all examined 48 cases. Ultrasound, MIBI and CT were done before operation after 1991, and accurate preoperative localization diagnosis was (obtained). Minimally invasive (parathyroidectomy) (MIP) was successfully completed in 39 of 45 cases, and the primary operation cure rate was 97.4%. At postoperative follow-up of 10 months to 10 years, with the (exception) of 15 cases of severe bone deformity that had no obvious improvement, the other symptoms and signs were all relieved to varying (extents), the laboratory markers returned to normal, and there was no permanent hypoparathyroidism or (recurrent) nerve injury or other complications.Conclusions Early diagnosis of PHPT and effective early (treatment) by surgical removal of the pathologic lesion can alleviate the occurrence of severe bone changes and deformity. The preoperative combined use of imaging localization technique and overall assessment can improve the accuracy of diagnostic localization of the lesion.

Objective To investigate the stimulating effects of activin A(ACT-A) and follistatin(FS) on the secretion of type I collagen(Col I) and the expression of Col I mRNA of cultured rat renal interstitial fibroblasts in vitro.Methods Rat renal interstitial fibroblasts isolated from normal SD rat renal medulla were cultured in vitro.The cells were divided into three groups:different concentrations of ACT-A(group A),different concentrations of FS(group F),and different concentrations of FS plus 30ng/ml ACT-A(group A+F).The expression of Col I mRNA in cultured rat renal interstitial fibroblasts was detected by RT-PCR,and the expression of Col I protein in cultured rat renal interstitial fibroblasts was examined by immunocytochemistry.Results Renal interstitial fibroblasts were successfully cultured in vitro.In present study,the expression of Col I mRNA increased significantly in cultured rat renal interstitial fibroblasts after stimulated by ACT-A in dose-dependent manner(P0.05).FS could inhibit the effects of ACT-A(30ng/ml) on Col I mRNA and Col I protein of the cultured renal interstitial fibroblasts in dose-dependent manner in A+F group(P

Objective:To investigate the change and related factors of nitric oxide,nitric oxide synthase level and cerebral blood flow(CBF) in panic disorder.Methods:30 patients with panic disorder,30 patients with generalized anxiety disorder and 22 normal controls entered the study.Serum level of NO and NOS were assayed.Cerebral blood flow were measured with TCD.Results:The concentration of NO was significantly lower in panic disorder group in comparison with GAD group.There was no significant difference in NOS level between panic disorder group and the control group.Cerebral blood peak flow velocity in the left and right middle cerebral artery and mean cerebral blood flow velocity in the right middle cerebral artery were lower than normal control group and the difference were very significant.Cerebral blood peak flow velocity in the right vertebral artery was lower than those of GAD and NC group.The concentration of NO in panic disorder was correlated with HAMA score negatively.Cerebral blood peak flow velocity in the left middle cerebral artery was correlated with mean Cerebral blood flow velocity in the left middle cerebral artery,peak CBF velocity in the right middle cerebral artery and psychological anxiety positively and correlated to cerebral blood peak mean velocity in the right middle cerebral artery,peak CBF velocity in the right anterior cerebral artery,age and female negatively.Cerebral blood peak flow velocity in the right middle cerebral artery has positive correlation with mean cerebral blood flow velocity in the right middle cerebral artery and peak CBF locity in the right anterior cerebral artery and negative correlation with cerebral blood mean flow velocity in the right anterior cerebral artery. Mean cerebral blood flow velocity in the right middle cerebral artery was correlated to cerebral blood peak flow velocity in the right middle cerebral artery,mean cerebral blood flow velocity in the left middle cerebral artery,cerebral blood mean flow velocity in the right anterior cerebral artery and NO level positively and age,cerebral blood peak flow velocity in the left middle cerebral artery and cerebral blood peak flow velocity in the right anterior cerebral artery negatively.Cerebral blood peak flow velocity in the right vertebra artery has positive correlation with cerebral blood mean flow velocity in the right vertebra artery and cerebral blood mean flow velocity in the left middle cercbral artery and negative correlation with cerebral blood peak flow velocity in the left anterior cerebral artery and cerebral blood mean flow velocity in the right anterior cerebral artery.Conclusion:The change of NO and cerebral blood flow may be one of the neurobiological mechanisms in panic disorder.To assay the level of NO and measure cerebral blood flow might become approach of diagnosis for panic disorder.

Objective To evaluate safety and effect of percutaneous balloon mitral valvuloplasty(PBMV) for patients with rheumatic mitral stenosis and left atrial thrombi.Methods PBMV was performed in 27 patients with rheumatic mitral stenosis and left atrial thrombi. 19 cases of left atrial fresh thrombi revealed by transesophageal echocardiography (TEE) received warfarin orally for 3-6 months before PBMV. Results PBMV was successful in all cases of mitral stenosis and left atrial thrombi. Left atrial fresh thrombi was completely resolved in 9 cases and became smaller chronic organized thrombi in 10 cases after warfarin anticoagulation treatment among 19 cases of left atrial fresh thrombi revealed by TEE. In 5 cases of left atrial chronic organized thrombi shown only transthoracic echocardiography and without anticoagulation treatment, one case had cerebral embolism. No complication occurred in other cases.Conclusions The study showed that patients with rheumatic mitral stenosis and atrial fibrillation should have routine TEE. PBMV for rheumatic mitral stenosis with left atrial thrombi after anticoagulation treatment is safe and effective.

Objective To discuss the effect and the method of treatment of anti-cardiolipin antibody (ACA),ANA and ENA on abnormal delivery women,and their relationship with abnormal delivery.Methods The concentrations of plasman ACA,ANA,ENA and the times of abortion in abnormal delivery for 193 cases of abnormal delivery women and 100 cases of normal pregnancy were quarnlitatively detected and satistically analyzed.The 81 ACA positive patients were treated orally with aspirin,25 ACA and ANA/ENA positive patients were treated with aspirin combined with prednisone,and 3 ANA/ENA positive patients with prednisone treatment oral.Results The number of ACA and ANA positive patients was closely related to the types of abmormal delivery. The ANA and ENA positive patients was related to the times of abortion. There was no difference in the outcome of treatment between both therapies of aspirine and aspirine combined with prednisone in abnormal delivery women.Conclusions ACA is an important factor in causing abnormal delivery. No matter what ANA and ENA are in ACA positive patients,their can be treated with aspirin alone.