In Africa about 133 million people lived with disabilities which were mainly the sequelae of infectious disease, war or trauma accidents, single organ dysfunction, refractive error and some others. Medical rehabilitation and community-based rehabilitation could only meet 5%~55% of their rehabilitation needs. Weak infrastructure, poverty and lack of funds, negative attitudes and the monotonous human and culture environments restricted the development of rehabilitation medicine in Africa. Chinese model of rehabilitation medicine seemed to be suitable for Africa. Chinese medical teams in Africa could do a lot in admissions of the disabled, improving hardware conditions,training of professionals, developing new technology and expanding the prestige of rehabilitation medicine.

Objective To investigate the protection of metformin on kidney in non-diabetic hypertension elderly.Methods The patients was divided into two groups;one given nifedipine ,another given nifedipine plus metformin. Three months Later,the changes of body mass index (BMI), plasma insulin, urine protein, blood urea nitrogen(BUN), blood and urine ? 2-microglobulin(? 2-MG) were examined. Results Above-markers were reduced more remarkably in nifedipine plus metformin group than that in only nifedipine group(P

Objective: This paper aims to examine the current situation of information integration platform construction in tertiary hospitals in China, and explore the existing problems in the development of the integrated platform.Methods: This paper studies the current situation of the development of the medical integration platform through literature, and the relevant data of the status quo of the information integration construction was obtained through the National Level 3 Hospital Information Interoperability Standardization Construction Survey Report (2015), and descriptively analyzed the hospital medical integration Platform construction of the specific circumstances.Conclusion: From this research, it is concluded that there is a lack of unified planning in the construction of the medical integration platform of the tertiary hospitals in China, which is post-repair.The data is difficult to share, the data security loopholes and hidden dangers still exist.Therefore, it will be very helpful to plan the standardization of hospital information integration platform and the construction of information security, deepening the integration of medical information on the lower level and other measures to solve the problem, this paper puts forward the overall plan for the hospital integration platform.

Objective To investigate the pathogen and drug susceptibility in appendical intracavity with appendicitis, and guide clinically the selection of reasonable antibiotics. Methods Germicultures and drug susceptibility tests were conducted for the secretions from appendical intracavity of the 71 patients with appendicitis. Result (1) Totally 9 species (63 cases) of bacterium were isolated from clinical samples, positive rate of isolation was 88.7%. The first one was escherichia coli (49 cases). (2) The positive rates of germiculture were no differences in patients with different types of appendicitis. Age and BMI were associated with the results of germiculture. Gender, temperature, neutrophil, fecalith were not associated with the positive germiculture. (3) The curative effect of the third and the fourth generation cephalosporins and carbapenems were well. The curative effect of the first generation cephalosporins, quinolones and penicillins were not well. Conclusion (1)In all samples,escherichia coli are the dominant species of bacterium. The distribution of isolation is no difference in patients with different types of appendicitis. (2) The third generation cephalosporins are commonly used in clinical treatment with the obvious anti-bacteria effects, The fourth generation cephalosporins and carbapenems can act as the optimal drug for serious infection. Quinolones is not the optimal antibiotics. Penicillins antibiotic is not proposed to be used.

Objective To systematically evaluate the role of laparoscopic living donor hepatectomy in living donor liver transplantation (LDLT).Methods A systematic literature search was conducted on Medline-Pubmed,Embase,Cochrane Library to find studies on laparoscopic living donor hepatectomy for LDLT.All extracted data were analyzed using the RevMan 5 software.Results Ten studies with a total of 1 059 participants were included in this analysis.Laparoscopic donor hepatecomy (LDH) was associated with significantly less intraoperative blood loss [SMD =-0.39,95％ CI (-0.73,-0.05),P ＜ 0.05],lower peak level of postoperative total bilirubin [SMD =-0.24,95％ CI (-0.47,-0.01),P ＜ 0.05]and longer operative time [SMD =0.50,95％ CI (0.04,0.96),P ＜0.05] when compared with those operated with open surgery.On subgroup analyses,hospitalization stay decreased in patients who underwent LDLT with grafts obtained by complete living donor hepatectomy (LDH) and left lateral sectionectomy (both P ＜ 0.05).LDH was comparable to open surgery in donor complication rates and in-hospital cost (P ＞ 0.05).There were no differences on the harvested liver graft size,ischemic time,recipient postoperative liver function and complications between the two groups (P ＞ 0.05).Conclusions Laparoscopic hepatectomy in living donor is a safe procedure for graft-harvesting,which improved the clinical outcomes of the donor,liver graft and recipient in LDLT.It has also the advantages of reduced blood loss,low peak levels of postoperative total bilirubin and short hospitalization stay.

Objective To explore the value of lipidic degradation in puparium cases of C.megacephala during weathering in postmortem interval estimation. Methods The puparium cases of reared C.megacephala were collected, and laid outdoor. They were taken back 5 days and 10 days later, and then be stored at -20℃. The samples of control group were cleaned and cryopreserved immediately. The spectra were collected and preprocessed. The peak position and peak height were read and performed statistical analysis by SPSS 19.0 software. Results Compared to control group, the positions of Vas CH3 band showed no shift, and the Vas CH2 band showed blue shift, meanwhile, the Vs CH2 band disappeared in both experimental groups, moreover, the Vs CH3 band showed red shift only in 10d group;except of the Vs CH3 band in 5d group, the intensities of both the other two lipidic bands reduced in both experimental groups. Compared with 5day group, the Vs CH3 band showed red shift in 10d group, meanwhile, the differences of all the lipidic bands had statistical signiifcance. Conclusion Detection of lipidic degradation in puparium cases of C. megacephala during weathering by micro-FTIR provides a novel way to estimate postmortem interval and performs its potential for forensic applications.

Objective To investigate the effects of pentobarbital sodium on compound muscle action potentials (CMAPs) in rats.Methods Ten adult Sprague-Dawley rats (5 males,5 females),aged 8 weeks,weighing 240-260 g,were anesthetized with intraperitoneal 1％ pentobarbital sodium 40 mg/kg.The sciatic nerve was stimulated (intensity 0.50,0.55 and 0.60 V,wave length 0.05 ms,frequency 10 Hz) starting from 8 min after administration.Each intensity was repeated three times at 1 s interval.The stimulation mentioned above was repeated every 5 min.CMAPs from the gastrocnemius muscle were recorded starting from 8 min after administration (T1) and then were recorded every 5 min for 9 times (T2-10),Results The peak value of CMAP was significantly decreased at T3-5 when the intensity was 0.50,0.55 and 0.60 V,and CMAP latency was significantly prolonged at T3-6 when the intensity was 0.50 V,and at T4,5 when the intensity was 0.55 and 0.60 V as compared with those at T1 ( P ＜ 0.05 or 0.01 ).Conclusion Pentobarbital sodium can inhibit CMAPs in rats.

BACKGROUND: Subsequent to liver transplantation, pulmonary infection and new drug resistant strain frequently appear due to complex pathophysiological changes and abuse of antibiotics.OBJECTIVE: To collect the clinical data of 6 cases who underwent liver transplantation, and analyze the prevention and treatment measures of pulmonary infection after liver transplantation.DESIGN, TIME AND SETTING: Retrospective case analysis, performed in the Department of Hepatobiliary Surgery,First People's Hospital of Guangzhou between January and December 2004.PARTICIPANTS: Six cases that underwent liver transplantation and received treatment in the First People's Hospital of Guangzhou were recruited in the present study. All 6 cases underwent selective homologous whole liver transplantation, 5cases underwent modified orthotopic piggyback liver transplantation, and only 1 underwent classical orthotopic liver transplantation.METHODS: The clinical data of the 6 cases were retrospectively analyzed. After transplantation, basic disinfection,isolation, infection-protection measures should be taken. In addition, etiological information was collected. Chest X-ray was underwent to know the lung at the early stage. Aseptic manipulating was strictly performed during sputum aspiration.Gastrointestinal decompression and non-obstructed drainage were maintained to prevent aspiration. Moreover, preventive anti-infective treatment against the bacteria, fungi, and viruses was performed.MAIN OUTCOME MEASURES: Pulmonary infection and curative effects subsequent to liver transplantation.RESULTS: Of the 6 cases, 5 presented with pulmonary infection, including 1 at 4-11 days after transplantation and 1 at 1day after transplantation. One case died of respiratory failure. The remaining 5 cases were cured after standardized anti-infection, respiratory therapy, sputum aspiration, and nutritional support.CONCLUSION: Application of effective antibiotics, aseptic operation in sputum aspiration, and unobstructed respiratory tract drainage are important measures for treating pulmonary infection subsequent to liver transplantation.

Objective To investigate lymph node metastases in distal gastric cancer and its clinical significance. Methods From June 2006 to December 2007, 129 distal gastric cancer patients underwent radical gastrectomy with lymphadenectomy. Dissected lymph nodes were collected in groups, and histopathological studies were performed to detect lymph node metastasis. The relationship between lymph node metastasis and tumor parameters such as diameter, location, infiltrating depth, histological category,Borrmann typing was evaluated. Results Lymph node metastases was found in 80 out of 129 patients (62%). A total of 3295 lymph nodes were harvested with an average of 25.54 lymph nodes per patient,among those 889 lymph nodes were identified with metastasis. The metastasis rate was 18.60%, 48. 84%,37. 98%, 38. 76%, 44. 19%, 31.01%, 10. 85%, 14. 73%, 4. 65%, 1.55% and 0. 78% respectively in No. 1, No. 3, No. 4d, No. 5, No. 6, No. 7, No. 8a, No. 9, No. 11 p, No. 12a, No. 14v lymph node group.No. 3 and No. 6 group nodes were moat frequently invaded by metastasis. Conclusion This study provides the regular pattern of lymph node metastasis in distal gastric carcinoma patients undergoing radical gastrectomy and perigastric lymphadectomy which helps to guide lymphadectomy in terms of less trauma and favorite prognosis.

Objective To investigate the prevalence of macrosomia in China and the risk factors.Methods By stratified cluster random sampling,the medical records of 101 723 singleton term infants born in 37 hospitals nation wide (in 14 provinces) from January 1,2011 to December 31,2011 were reviewed.Adjusted odd ratio (aOR) and 95％ confidence interval (CI) were used to describe the risk factors.Population attribute risk (PAR) was used to quantitatively describe the associations between risk factors and the prevalence of macrosomia.Results The general prevalence of macrosomia was 7.3％ (7403/101 723).The prevalence varied among provinces (4.1％ to 13.4 ％).Logistic regression analysis showed that macrosomia were positively associated with living in northern China (aOR =1.4,95 ％ CI:1.2 ～ 1.6,PAR =19.9 ％),maternal age ≥ 35 (aOR =1.1,95％ CI:0.9～1.3,PAR=8.7％),pre-pregnant BMI≥28 (aOR=3.6,95％ CI:2.9～4.5,PAR=15.1％),gravidity＞1 (aOR=1.2,95％ CI:1.1～1.4,PAR=10.8％),parity＞1 (aOR=1.8,95％ CI:1.5～ 2.1,PAR=10.1％),maternal height≥160 cm (aOR =1.6,95％ CI:1.4～ 1.9,PAR=29.5％),gestational weight gain (GWG) ≥16 kg (aOR=2.2,95％ CI:1.9～2.4,PAR=25.2％),gestational diabetes mellitus (aOR=1.2,95％ CI:1.0～ 1.3,PAR =3.2％),gestational weeks≥40(aOR=2.4,95％ CI:2.1～ 2.7,PAR=34.4％)and baby boy (aOR=l.6,95％ CI:1.4～1.8,PAR=25.4％).Maternal BMI,gestational week and GWG were most strongly associated with macrosomia.Conclusions The prevalence of macrosomia varied dramatically between different areas in China.Pre-pregnancy BMI,gestational week and GWG,as the main modifiable risk factors for macrosomia,need more attention from health care providers.