0.05], whereas it is significantly decreased in ACEI group[(69.3?14.6)ml?min-1? (1.73 m2)-1 vs (63.5?16.4)ml?min-1?(1.73m2 )-1,P

Objective To discuss the feasibility and superiority of EST combined with LC in treating cholecystolithiasiswith common bile duct stones.Methods Patients underwent LC(laparoscopic cholecystectomy) preceded by EST(endoscopic sphincterotomy) and removal of common bile duct stones.ENBD(Endoscopic nasal biliary drainage tube)was placed if EST failure and then the patient underwent LC+laparoscopic biliary duct exploration(LCBDE),or open operative bile duct exploration.Results In 91 of the 99 cases,LC preceded by EST and stone removal was successful,while EST following LC was successful in 3 cases,and stone removal by EST was unsuccessful in 3 cases.Two cases less than 15 years of age underwentLC+LCBDE through the cystic duct and did not undergo EST.Three cases,who had EST failure,underwent LC+LCBDE with primary suture of the common bile duct or LCBDE with T-tube drainage of commonbile duct,or open bile duct exploration with primary suture of the common bile duct(ENBD was in place).All patients were discharged from hospital without serious complications.Conclusions EST combinedwith LC in treating cholecystolithiasis with common bile duct stones is a safe and effective method.Combination of endoscopic and laparoscopic procedures fully reflects the advantage of minimally invasive therapy.

Objective To realize the isolation of multidrug-resistant organisms (MDROs)from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO in-fection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected pa-tients without MDRO infection were as control group,environmental object surface in patients’ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility tes-ting.Results Of 44 patients with MDRO infection,13 patients’surrounding environment were detected MDROs,the total detection rate was 29.55%(13/44).The detection rate of methicillin-resistant Staphylococcus aureus (MRSA),multidrug-resistant Acinetobacter baumannii (MDRAB),and methicillin-resistant Staphylococcus epidermidis (MRSE)were 45.45%(5/11),66.67% (2/3)and 66.67%(6/9)respectively.Detection rates of MRSA from nasal cavity and hands of MRSA-infected patients were 72.73% and 54.54% respectively,from nasal cavity and hands of patients’caregivers were 36.36%and 18.18% respectively.The difference in bacterial count between trial group and control group was not significantly dif-ferent (all P >0.05).Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients’surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.

Now medical undergraduates are faced with a series of problems in the clinical practice.Instructors should work well on students' education work to improve the effect and quality of clinical practice.

According to the training of all levels and all kinds of personnel during our hospital's digital construction and implementation process,this article discussed the training char-acteristic of computer skill and the teaching principle for doctors and nurses

Objective To explore the diagnosis,treatment and nursing of the patients complicated with pneumocystis carinii pneumonia (PCP) after renal transplantation,and to enhance the treatment effect of the disease.Methods The treatment and nursing processes of 37 patients complicated with PCP after renal transplantation in department of organ transplantation were retrospectively analyzed in the First Affiliated Hospital of China Medical University from May 1992 to July 2011.And the key points during nursing work were summarized.Results Of the total 37 patients,10 patients occurred respiratory failure,they were all treated by noninvasive ventilation,among which 6 patients were converted to tracheal intubation or tracheotomy mechanical ventilation.5 patients appeared rising serum creatinine(Scr) during treatment,but recovered to normal level after discontinuing SMZco for 1 week.4 patients died unfortunately,and the others were cured and discharged.Conclusions The occurrence of PCP after renal transplantation is closely related to the immune state of the patients,thus the priority of treatment for PCP should be prevention.Once happened,nursing care in aid is particularly important,then nurses should encourage patients to cooperate with treatment,relieve symptoms after infection,and promote recovery as well.

Objective To investigate the refraction change and nursing character in myopic amblyopia during the perceptual learning treatment. Methods Refraction of 54 children (98 eyes) with myopic amblyopes were selected,which were selected from the amblyopia clinic between 2007 and 2009, the spherical diopter, astigmatism and spherical equivalent were collected before and after perceptual learning,the refractive dynamic was compared according to the degree of amblyopia. Results The spherical average annual growth of myopic amblyopia during treatment was 0.52D, the growth of astigmatism was 0.03D;the spherical equivalent average annual growth was less than 0.50D accounted for 57.14%. The dynamic changes of spherical or SE of mild, moderate and severe amblyopia had significant difference, but the cylinder had not significant difference in change. Conclusions The treatment of perceptual learning in patients has little effect on the growth of refraction in myopic amblyopia, however, it is still necessary to pay close attention to refraction changes of in myopic amblyopia in the course of treatment.

OBJECTIVETo explore the rhythm regulatory mechanism of interleukin-6 (IL-6) in the process of moxibustion for rheumatoid arthritis (RA).

METHODSA total of 144 Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a moxibustion group, a sham operation group, an operation group, an operation+moxibustion group, 24 rats in each one. Each group was divided into 4 time points (0:00 am, 6:00' am, 12:00 am, 6:00 pm), 6 rats in each time point. The Light-Dark 12 : 12 was given in all rats for light-dark cycle. Except the blank group, rats in the remaining groups were treated with intracutaneous injection of freund's complete adjuvant at right-side foot to establish the model of RA. After the model establishment, bilateral adrenal, glands were removed in the operation group and operation + moxibustion group, while those in the sham operation group were not removed with identical operation procedure. Rats in the moxibustion group and operation + moxibustion group were treated with grain-sized moxibustion from 7:00 am to 9:00 am at "Shenshu" (BL 23) and "Zusanli" (ST 36) once everyday, 6 times were taken as one session and 3 sessions were required tatclly, while rats in the remaining groups received identical fixation without moxibustion. The general health state and foot volume of rats were measured before model establishment, after establishment and after treatment. After treatment, rats were sacrificed at each time point to collect the blood sample and measure the content of IL-6 by using enzymne-immunoassay method.

RESULTSCompared with the blank group, the foot swelling in the model group was obviously increased (P<0. 05); the IL-6 maintained circadian rhythm (P<0. 05), but the peak phase had a backward trend, famplitude had an increased trend and the median was significantly lifted (P<0. 05). Compared with model group, !the foot swelling in the moxibustion group was obviously decreased (P<0. 05); the IL-6 maintained circadian. rhythm (P<0. 05), and the peak phase had a forward trend, amplitude had a decreased trend and the median was significantly reduced (P<0. 05). Compared with the moxibustion group, the foot swelling in the operation--moxibustion group was obviously increased (P < 0.05); the IL-6 maintained circadian rhythm (P < 0.5), but the peak phase moved forwrd, and the median was significantly elevated (P < 0.05).

CONCLUSIONThe IL-6 in plasma maintains significant pathological circadian rhythm in RA rats; with the complete hypothalamic-pituitary-adrenal axis, moxibustion is likely to regulate the circadian rhythm of IL-6 to play an important role of anti-inflammatory effect in RA rats.

Acupuncture Points ; Animals ; Arthritis, Rheumatoid ; metabolism ; physiopathology ; therapy ; Circadian Rhythm ; Disease Models, Animal ; Female ; Humans ; Hypothalamus ; metabolism ; Interleukin-6 ; metabolism ; Male ; Moxibustion ; Pituitary-Adrenal System ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors

Objective: To detect anti tubular basement membrane antibodies in sera from patients with tubulointerstitial nephritis (TIN) and investigate its clinical significance. Methods: The sera were studied from 46 patients with renal biopsy proven TIN. The normal human renal cortex was obtained from patients with nephroectomy, far from carcinoma. Tubules were isolated by a differential sieving technique. The fragments of renal epithelia were removed from tubular basement membrane enriched materials by sonication and centrifugation. Tubular basement membrane antigens were solubilized with 6 mol/L guanidine HCl. The soluble proteins were used as antigens in Western blot analysis to detect autoantibodies in sera from patients with TIN. The clinical characteristics of positive and negative patients were statistically analyzed. Results: Eleven patients with tubulointerstitial nephritis had anti tubular basement membrane antibodies by Western blot analysis, and seven protein bands could be blotted by the TIN sera. The positive prevalence of anti 55?10 3 antibody (63.8%) was higher than that of other antibodies. Eight of 27 (29.6%) patients with acute tubulointerstitial nephritis and four of 19 (21.1%) patients with chronic tubulointerstitial nephritis had anti tubular basement membrane antibodies. ESR,serum IgG and IgM in patients with acute TIN with positive anti tubular basement membrane antibodies were higher than those of the negative group There was no significant difference in the other clinical variables such as gender,age,hemoglobin,complement C 3,serum IgA,serum creatinine,blood urea nitrogen and creatinine clearance in patients with acute TIN between the positive and negative groups .There was no significant difference in clinical variables mentioned above in patients with chronic TIN between the positive and negative groups. Conclusion: Circulating anti tubular basement membrane antibodies could be detected in sera from some patients with TIN, and autoimmunity may play a role in the pathogenesis of TIN.

Objective: To study the method of setting up,practicability and the cardiovascular physiological mechanism of slippery pulse model caused by alcohol.Methods: ①Scanned the heart and radial artery(cunkou) by the Magnetom Avanto 1.5T and record the pressure wave of radial artery by NX-6 Pulse Diagnosis Equipment after the subjects had gotten 100ml of distillate spirit of 61 degree and defined as the slippery pulse.②Record the pressure wave of carotid artery of rabbits defined as the slippery pulse after intragastric administration of distillate spirit of 40 degree 8ml per kilogram by NX-3 Pulse Diagnosis Equipment.Results: ①Slippery pulse model of human subjects: the stroke volume(SV),cardiac output(CO),cardiac index(CI),ejection fraction(EF) and the peak velocity of the blood flow increased;the end-diastole volume(EDV) and end-systole(ESV) decreased;the periph blood vessel distended and the amplitude of the offset of the axis stepped up;the characteristics of the pulse wave of cunkou were consistent with the characteristics of typical slippery pulse wave.②The characteristics of the pulse wave of slippery pulse model of rabbits were coincident with that of human subjects.Conclusion: The method of setting up slippery pulse model with alcohol is consistent with the mechanism of slippery pulse in the theory of traditional Chinese medicine and is practicable.