Objective To observe the effect of triple therapy to the levels of serum interleukin 10(IL)-10 ,transforming growth factor beta 1(TGF-β1) and IL-17 in eldly patients with helicobater pylori associated gastritis .Methods 90 eldly patients with heli-cobater pylori associated gastritis were randomly divided into observation group and control group ,45 cases in each group ,the ob-servation group was given standard triple therapy ,the control group was separately given omeprazole treatment ,after 14 days , ELISA method was used to detect the levels of serum IL-10、TGF-β1 and IL-17 .Results Compared with before treatment ,the lev-els of IL-10、TGF-β1 and IL-17 in of the two groups had significantly reduced after treatment (P<0 .05);compared with the control group after treatment ,the levels of IL-10、TGF-β1 and IL-17 in observation group after treatment had significantly reduced (P<0 .05) .Compared with helicobater pylori negative and helicobater pylori positive patients of the experimental group after treatment , the levels of IL-10、TGF-β1 and IL-17 had significantly reduced(P<0 .05) .The levels of IL-10、TGF-β1 and IL-17 in serum of pa-tients of two groups before treatment showed significantly positive correlation (P<0 .05) .Conclusion The triple therapy could sig-nificant decrease the levels of serum IL-10、TGF-β1 and IL-17 ,it has good treatment effect .

Objective To explore the clinical efficacy and adverse reactions of transarterial chemoembolization(TACE)combined with sorafenib for the treatment of liver carcinoma.Methods Forty-eight cases of intermediate-advanced liver carcinoma patients were divided into TACE combined with sorafenib group(test group)and TACE only group(control group)according to the wishes of the patient,with 24 patients in each group.The median Survival Time(mOS),clinical efficacy,quality of life,liver function indexes and adverse reactions were compared in two groups.Results Until the deadline of follow-up time,the mOS in test group(15.9 months)was significantly higher than that in control group(9.3 months).The difference was statistically significant(P<0.05).The ORR,CBR in test group(58.3%,87.5%)were significantly higher than those in control group(33.3%, 54.2%).The difference was statistically significant(P<0.05).The quality of life improvement rate in test group(79.2%)was significantly higher than that in control group(37.5%).The differences were statistically significant (P<0.05 ).The ALB,TBIL increased significantly after treatment than before treatment in both groups.The differences were statistically significant(P<0.05 ).Conclusion TACE combined with sorafenib is more efficiency than TACE only treatment,and it could effectively extend the period of life to guarantee the quality of life.What's more,it has well tolerated adverse reactions,which is worthy of promoting.

Objective To evaluate the association between stress hyperglycemia and clinical out-comes among patients with and without diabetes mellitns admitted to medical intensive care unit (MICU).Methods We reviewed the medical ICU records of 1016 consecutive patients admitted to Wu Han Univer-sity Ren Min Hospital. According to admission glucose level, 126 patients with debates and 890 patients without known debates were divided into group 1 ( <6 mmol/L), group 2(6 ～ 8mmol/L), group 3(8 ～10mmol/L), and group 4( > 10mmol/L). The primary end point of the study was in-hospital mortality. Secondary end points included length of hospital stay, length of ICU stay, the ratio of mechanical ventila-tion, blood transfusions, antibiotics and blood glucose treatment. Results The hospital mortality among patients without a history of diabetes mellitus was 4. 7%, 12. 1%, 20. 5%, 30. 3% in group 1, 2, 3, 4,respectively. The ratio of mechanical ventilation, blood transfusions, and antibiotics increased progressively as glucose values increased. Conclusions Hyperglycemia was a common disease, and it may be an impor-tant marker of poor clinical outcome and mortality in patients without history of diabetes.

Objective　To discuss the methods of treatment of sellar region tumors by microsurgery via modified transpterional approach.Methods　The clinical data of 326 patients with sellar region tumors were retrospectively analyzed. All of the patients(of them 158 patients with pituitary adenomas, 89 patients with craniopharyngiomas and 79 patients with meningiomas)were treated by microsurgery via modified transpterional in our hospital in recent 4 years. The most important part of preoperative arrangement was giving glucocorticoid and anti-epilepsy drugs. Modified transpterional craniotomy was performed, and the tumors were removed by employing microsurgical techniques via the 5 anatomy interspaces in sellar region after the subarachnoid cisterns were dissected carefully under surgical microscope. Consciousness, urine volume and serum electrolyte of the patients were observed strictly after surgery, and the complications such as diabetes insipidus, serum electrolyte disorder and epilepsy were remedied in time.Results　The rate of intact frontal branch of facial nerve was 92.18% and that of intact supraorbital nerve was 95.72%. Atrophy of temporal muscle occurred in none of the patients. Total and/or subtotal resection of tumors was achieved in 95.26% patients and the rate of intact pituitary stalk was 62.44%. The major postoperative complications included diabetes insipidus and serum electrolyte disorder. Although the incidence of complications was high to 61.42%, complete restore was achieved in 97.12% of the patients with the complications within 1 month.Conclusion　The modified transpterional approach for sellar region tumors may give a lower incidence of damage to frontal branch of facial nerve, super-orbital nerve and temporal muscle, and it can achieve higher total resection rate and a less postoperative complications by employing modified transpterional approach and the microsurgical techniques, combined with the active treatments of postoperative complications, therefore it is deserved to be spread to use in clinical works.

Objective To investigate the methods of total resection of craniopharyngioma and treatment of postoperative complications. Methods The abscission of CPG was performed in 24 patients with craniopharyngioma (CPG) which situated at sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were remedied in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. All of the patients were sober after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder took place in 16 cases,12 cases, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, but diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope which tumor invades and being familiar with the 4 sellar anatomy spaces so as to be used correctly in operation are the keys to remove the CPG completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus, serum electrolyte disorder can decrease mortality observably.

Objective To study the psychological defence (PD) and coping style (CS) of the patients suffering depressive episode (DE).Methods 104 cases of the experimental group and 104 cases of the control group,which were stratified sampled,had been investigated by applying defensive style questionnaire (DSQ),coping style questionnaire(CSQ).Results The total score of the immature PD of the experimental group(5.19±0.73) was significantly higher (t =2.93,P＜ 0.05) than that of the control group (4.41 ± 0.76).In the immature mechanism,withdrawal,somatization,avoiding,passive aggression were significantly higher,but the complaints and fantasy were significantly lower.The total score of mature PD of the experimental group(4.49±0.61) was significantly lower (t=-6.02,P＜0.01) than that of the control group(6.01±0.85).For the mature mechanism,sublimation and humor were lower and the repression was higher.And for the CS,problem solving,consulting and rationalization scores were significantly lower than those of the control group(t=-4.58,P＜0.01 ; t=-4.49,P＜0.01; t=-4.01,P＜0.01).The self-accusation,retreat scores were significantly higher than those of the control group(t=8.21,P＜0.01; t=5.31,P＜0.01).Conclusion Patients suffering DE are apt to use immature PD and CS.To increase the therapeutic effect,the style of the patients' PD and CS should be highlighted,and it is necessary to take steps to guide the patients to use mature PD and CS.

Objective To investigate the method of total resection of craniopharyngioma and prevention and treatment of post-operative complications. Methods Pterion craniotomy was performed in 24 patients with craniopharyngioma which was situated in sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine volume, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were treated in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. There was not obvious deficit of nervous system function in all of the patients after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder occurred in 16 cases, 12 case, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, and diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope of tumor invasion and being familiar with the 4 sellar anatomy spaces were the keys to remove craniopharyngioma completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus and serum electrolyte disorder could effectively decrease mortality.

Objective To evaluate the effects of laparoscopic filling with pedicled greater retina for hepatic cysts. Methods Clinical data were reviewed on 36 patients with hepatic cysts undergoing laparoscopic filling with pedicled greater retina from January 2010 to May 2014.The diameters of cysts ranged from 10 to 26 cm, with a diameter smaller than 20 cm in 29 patients and bigger than 20 cm in 7 patients.Laparoscopic fenestration of hepatic cysts was performed to destroy cyst cells with iodine and absolute alcohol. Pedicled greater retina was used for filling the cavity of cysts. Results The procedures were completed smoothly.The operative time was 45-115 min, with an average of (80.4 ±13.1) min.No abdominal cavity infection happened.Primary healing of abdominal incision was achieved in all the patients.The postoperative hospital stay was 5-10 d, with an average of (6.4 ±1.2) d.All the 36 patients were followed up for 6-12 months with a mean of (9.3 ±1.5) months.None of the patients showed recurrence under liver B-ultrasonography or CT scanning. Conclusion Laparoscopic filling with pedicled greater retina for hepatic cysts has advantages of minimal invasion, quick postoperative recovery, short hospital stay, and good results.

This paper introduces ADO technique of exploiting database in VC ++.Through the design of soldier information database,it presents the realization of SQL Server database programming technology based on ADO in VC++,then dwells on the essential steps of database programming.

Objective To observe the analgesic effects of preoperative tramadol caudal injection in patients after receiving gynaecological laparoscopy under general anesthesia. Methods A total of 60 patients scheduled for gynaecological laparoscopic operations under general anesthesia was randomly divided into two groups with 30 patients each.The Group A was given an injection of tramadol 100 mg,2% lidocaine 5 ml,ondansetron 4 mg,and normal saline 20 ml by caudal route preoperatively,while the Group B was given an intravenous drip of tramadol 100 mg and ondansetron 4 mg at 10 minutes before the end of operation.The Visual Analog Scale(VAS) pain scores and the Ramsay Sedation Scores were recorded after extubation,before the departure from operation room,and at 1,3,and 6 hours after surgery,respectively.Adverse effects of dysphoria,dizziness,drowsiness,nausea,and vomiting were recorded.Results The VAS scores were significantly lower after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=-5.961,-8.362,-4.038,-3.565;P=0.000), while the difference was not significant between the two groups at 6 hours after surgery(t=-1.403,P=0.166).The Ramsay scores were significantl higher after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=9.409,10.407,8.167,4.082;P=0.000),while the difference was not significant between the two groups at 6 hours after surgery(t=0.428,P=0.670).Significantly more patients presented dysphoria,dizziness,nausea,and vomiting in the Group B than in the Group A after extubation and before the departure from operation room.Conclusions Tramadol 100 mg caudal injection before operation can produce a better postoperative analgesic effect in patients receiving gynaecological laparoscopic operations.