Objective To investigate the curative effects of laparocopic treatment for cystiduodenal internal fistula. Methods All procedures were conducted under laparoscope. After the exposure of the cholecystic base, trans-cholecystic cholangiography was performed to detect the relations between the cholecyst and neighboring organs. Once the internal fistula was confirmed, the orifice of fistula was closed laparoscopically. Then abdominal drainage, gastrointestinal decompression, and administration of somatostatin were routinely employed. Results In a series of 327 cases of laparoscopic cholecystectomy (LC) with intraoperative cholangiography, a total of 6 cases of cystiduodenal internal fistula were detected, all of which were anatomized and closed successfully under laparoscope. No postoperative hemorrhage or duodenal bile leakage occurred. Conclusions Routine intraoperative cholangiography during LC is beneficial to the detection of the cystiduodenal internal fistula.Effective and reliable management rests upon skillful laparoscopic techniques of dissection and fistula closure, as well as the supportive treatment.

Objective: To study the probiotic properties of 12 selected strains of lactobacilli.Methods: The probiotic properties of 12 selected strains of lactobacilli were investigated for their resistance to pH 2.5 and 0.3% oxgall,their adhesion to Caco-2 cells and antimicrobial activity against enteric pathogenic bacteria.Results: The 12 strains all showed relatively high resistance to acid and bile salt and varied antimicrobial activities against pathogenic bacteria of intestinal infection.Lactobacillus johnsonii JCM1022 exhibited a broad inhibitory effect on enteric pathogenic bacteria,especially on enteropathgenic E.coli and Salmonella enteritidis,while Lactobacillus reuteri JCM1081 possessed a high activity of adhesion to Caco-2 cells(495.07?80.03).Conclusion: Among the 12 strains,Lactobacillus johnsonii JCM1022 and reuteri JCM1081 are qualified candidates for clinical application.

Objective To understand the basic circumstance of the hospital infection,and to improve the knowledge of medical staff on the management of hospital infection.Methods With bedside observation and examination combined with checking clinical case history,462 inpatients were investigated on current rate of hospital infection and its related factors.Results There were 30 inpatients suffering from hospital infection,the current rate of the hospital infection was 6.49 %;among them,the rate of the lower respiratory tract accounted for 33.00%.The current rates of hospital infection in inpatients with antibiotics(16.56%),or with treatment of urinary catheters(18.52%),or with operation(16.30%),with more than one month hospitalization(19.05%) were significantly higher than those of inpatients without antibiotics(1.00%),without treatment of urinary catheters(5.75%),without operation(4.05%) or with less than one month hospitalization(4.55%)(all P

Objective To investigate the status quo of application of fall risk factors assessment scale in nurses of different position in geriatric ward . Method Eighty-six nurses in different position were investigated by fall risk factors assessment scale . Results About 89 . 5%of the nurses could assess the fall risk factors on time and 80 . 2%could do it accurately , and only 62 . 8%of them worked out their nursing orders based on the possible falls. In terms of the accuracy in using fall risk factors assessment, the primary nurses was poorer than the senior nurses, with statistically significant difference between them (P<0.05). Yet there were no significant differences between them in timeliness and pertinence at working out nursing orders (P>0.05). Conclusion We should strengthen the training to the clinical nurses in correctly using the fall assessment scale , in order to exert the diagnostic value of the fall assessment scale, reduce the incidence of falls and ensure the safety of the patients.

Objective: To investigate the position and the size of ureteral stone in patients before treated with ureteroscopic lithotripsy or percutaneous nephrolithotomy (PCNL), as well as the dilatation of ureter caused by stone, which may be helpful for better understanding of pathogenesis of ureteral stone and improvement of the diagnosis and treatment in clinic.Methods: A total of 129 cases with ureteral stone for endourologic lithotripsy in Peking University People''s Hospital from Aug.2016 to Mar.2017 were included for the retrospective review.The CT data of the ureteral stones and the ureteral dilatation were collected, including the position of stone, the transverse and longitudinal diameter of stone, and the transverse diameter of dilated upper ureter and ureteropelvic junction (UPJ).The distribution of ureteral stones and dilatation in different parts of ureter were compared and analyzed.Results: All of the 129 cases of ureteral stone, stones were located at UPJ in 9 cases (7.0%), proximal ureter in 75 (58.0%), ureter crossing external iliac vessel (UEIV) in 6 (4.7%), distal ureter in 26 (20.2%), and ure-terovesical junction (UVJ) in 13 (10.1%).The mean transverse diameter of proximal ureteral stones was greater than that of distal ureteral stones [(8.47±2.36) mm vs.(6.74±1.99) mm, P<0.001], as the same as the mean longitudinal diameter [(11.00±4.41) mm vs.(7.50±4.28) mm, P<0.001].In 114 cases of dilated ureter for stone, the UPJ had a greater transverse diameter compared with the upper ureter [(14.39±6.09) mm vs.(11.45±3.85) mm, P<0.001].Conclusion: The most common location of stone is the proximal ureter in patients for endourologic lithotripsy, as the location in UEIV is rare.Both transverse and longitudinal diameters of stone in proximal ureter are greater than those in distal ureter.For dilated ureter, it is more severe in UPJ than in upper ureter.Traditionally, it is accepted that the stones lodge at 3 sites of natural narrowing in ureter, which may be questioned.

To meet the need of cultivating high-quality personnnel,enhance the medicalstudents' ability to analyze and solve problems,directing at the problems existed in pharmacology experiment,we have adjusted and reformed the content of the experiment teaching in pharmacology and conducted the survey and research among the students so as to lay a solid fundation to its reasonable implement.

The number, funds, types, undertakers and responders of National Natural Science Foundation-sup-ported projects in health policy and management from 2005 to 2014 and the changes in their contents were analyzed by sequential analysis and co-word analysis, respectively, in order provide evidence for decision-making of health policy and management , to help selection of future research topics on health policy and management , and to apply for funds for research on health policy and management .

SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Objective:To investigate the expression of myocardium connexin 43 (Cx43) in late exercise preconditioning (LEP) cardioprotection.Methods: Eight-week-old adult male Sprague Dawley rats were randomly assigned into four groups (n=8). Myocardial injury was judged in accordance with serum levels of cTnⅠ and NT-proBNP as well as hematoxylin basicfuchsin picric acid staining of myocardium.Cx43mRNA was detected byin situhybridization and qualified by real-time fluorescence quantitative PCR. Cx43 protein was localized by immunohistochemistry and its expression level was determined by western blotting.Results:The LEP obviously attenuated the myocardial ischemia/hypoxia injury caused by exhaustive exercise. There was no significant difference of Cx43mRNA level between the four groups. Cx43 protein level was decreased significantly in group EE (P<0.05). However, LEP produced a significant increase in Cx43 protein level (P<0.05), and the decreased Cx43 protein level in exhaustive exercise was significantly up-regulated by LEP (P<0.05).Conclusions:LEP protects rat heart against exhaustive exercise-induced myocardial injury by up-regulating the expression of myocardial Cx43.

Objective To investigate the prevalence of sleep-disordered breathing in elderly patients with permanent cardiac pacemaker implantation due to bradyarrhythmias, and the relationship between pacing mode and patients' sleep apnea-hypopnea index.Methods Forty-four elderly patients (＞60 years) with cardiac pacemaker and their 44 controls matched for gender, age, body mass index and cardiovascular morbidity were studied using polysomnography or portable sleep monitoring device. Results Prevalence of sleep-disordered breathing (apnea-hypopnea index ≥5/h) was 44.7% and the mean apnea-hypopnea index was 8.2 ±4.1/h in the cardiac pacemaker group, which were significantly higher than those in control subjects (25% and 4.6±2.4/h, respectively, P＜0.01 and P＜0.05). The mean apnea-hypopnea index of patients with DDD or AAI pacemaker was significantly lower than that of patients with VVI pacemaker. Conclusions Sleep-disordered breathing was more common in patients who had their cardiac pacemaker implanted due to bradyarrhythmias than in their matched controls. Compared with VVI pacing, DDD or AAI pacing may be more beneficial to patients with bradyarrhythmias and sleep-disordered breathing.