Objective To discuss the surgical skills and clinical value of laparoscopic splenectomy with a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen.Methods A total of 88 patients with hypersplenism secondary to liver cirrhosis who underwent laparoscopic splenectomy in our department from September 2015 to September 2016 were selected into this study.And these patients were divided into two groups based on whether to take the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The control group included 40 cases who underwent the traditonal laparoscopic splenectomy,while the observation group included 48 cases who took the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The clinical data were collected retrospectively by medical clinical records review.Results There was no mortality occurred in this study.The blood loss of the observation group was (247.50±135.89)mL,which was obviously lower than (361.75±144.43)mL of the control group,and the difference was statistically significant (P<0.05).The operation time of the two groups were (194.69±47.99)min and (232.75±45.26)min respectively,and the difference was statistically significant (P<0.05).No significant difference was found in terms of rate of conversion to laparotomy,rate of intraoperative blood transfusion,postoperative hospital stay and complications (P>0.05).Conclusion It is very crucial for a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen to establish a tunnel behind the splenic hilum in laparoscopic splenectomy.It is safe and feasible to perform a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The technique is generalized in clinics,especially for freshmen.

This paper introduces the rapid & mobile first-aid unit from brigade or regiment medical aid station,especially discusses its equipment,performance,personnel structure,and working features.The rapid & mobile first-aid unit can perform emergency operation and anti-shock treatment for the serious wounded in frontier at any moment.It meets the requirements in such aspects as fast & effective first-aid,mobile & flexible treatment,high cure rate and good practicality.

Objective To express the major allergen of Blattella germanica (Bla g 2) in Pichia pastoris and obtain the soluble protein. Methods The known Bla g 2 gene was used to design the primers which had the restriction enzyme sites. PCR method was applied to obtain the Bla g 2 gene. The gene fragment was then cut and ligated with the Pichia expression vector pGAPZaA, resulting in a recombinant plasmid pGAPZaA-Bla g 2. The linearized pGAPZaA-Bla g 2 was transformed into Pichia pastoris GS115 through electroporation, then screened to positive transformants, and the protein was expressed in YPD medium. Purification of the recombinant protein was achieved by metal (Ni2+) chelating affinity chromatography and Western-blotting assay indicated its IgE binding capacity. Results With the expressed reeombinanl protein, SDS-PAGE showed the presence of the product in the supernatant of the culture with Mr 45 000. After 3 days culture, the recombinant protein occupied 50% of the total proteins in the supernatant. The recombinant protein was purified and Western-blot demonstrated an adequate IgE binding capacity of the product. Conclusion A recombinant protein of Bla g 2 has been obtained, which is soluble in the supernatant and therefore can avoid a process of denaturalization and renaturation of the recombinant.

Objective To explore the incidence and characteristics of thyroid disease in early pregnancy and to provide a scientific basis for eugenics .Methods The chemiluminescence immunoassay was used to detect the concentrations of serum thyrotropin (TSH) ,free thyroxine (FT4) ,triiodothyronine (FT3) and thyroid peroxidase antibody (TPOAb) in 776 early pregnant women (<12+6 weeks ,experiment group) and 100 non‐pregnant child‐bearing women (control group) .The test results were analyzed accord‐ing to the different diagnostic criteria of early pregnancy and non‐pregnant childbearing women .Results The serum concentrations of TSH ,FT4 and TPO‐Ab had statistical differences between the experimental group and the control group (P<0 .05) .The inci‐dence rate of thyroid diseases in early pregnant women was 35 .05% ,which was significantly higher than 15 .00% in non‐pregnant childbearing women ,and the difference was statistically significant (P<0 .05) .The thyroid diseases in pregnant women of the ex‐perimental group were mainly hypothyroidism (9 .28% ) and sub‐clinical hypothyroidism (22 .94% ) ,compared with the control group ,the difference was statistically significant(P<0 .05) .Conclusion Early pregnancy has high incidence rate of thyroid disease , which can lead to birth defects .Therefore ,screening early gestation thyroid diseases should be paid attention to provide theoretical basis for eugenics .

The current paper, pivoting on an analytical survey of the teaching contents and curriculum system of post-education for rural medical personnel, pinpoints the problems existing therein, and explores the various approaches for reforming the teaching contents and curriculum system.

In the background of the crisis of doctor-patient relationship and the effectiveness of medical humanities education doubts we need to think about how to achieve,transform and reflect the value of doctors' understanding on their professional meaning,how to realize the functional significance of doctorpatient cooperation and how to make doctors put themselves in patients' place by the curriculum and its operating mechanism.This paper discussed the external environment and the microcosmic environment from the externality and connotation of the humanities curriculum.And the way to reflect and achieve the value transformation of the medical humanistic curriculum in the mechanism of education was considered.This paper put forward combining the institutional mechanism of policy leading,the subject mechanism that is the basis of the curriculum,the constitutive mechanism of curriculum system and the cultural mechanism to make students study and internalize,and made some suggestions.

OBJECTIVE:To investigate the effects of etomidate combined with propofol on painless gastrointestinal endoscopy and cognitive function of elderly patients. METHODS:Totally 90 elderly patients with painless gastrointestinal endoscopy were ran-domly divided into propofol group(30 cases),etomidate group(30 cases)and combination group(30 cases). Propofol group was given Fentanyl injection 1 μg/kg+Propofol injection 1.5 mg/kg;etomidate group was given Fentanyl injection 1 μg/kg+Etomidate injection 0.3 mg/kg;combination group was given Fentanyl injection 1 μg/kg+Propofol injection 1 mg/kg+Etomidate injection 0.15 mg/kg. The levels of SBP,DBP,HR,MAP and SpO2 at different time points,examination time,anesthesia induction time,recov-ery time and recovery time of orientation were observed in 3 groups. NCSE and MMSE score at different time points,the occur-rence of ADR were also observed in 3 groups. RESULTS:During examination,SBP,DBP,MAP and SpO2 of propofol group were significantly lower than before anesthesia,after examination and those of combination group,with statistical significance(P<0.05);but there was no statistical significance in above indexes of propofol group between during examination and before anesthesia (P>0.05). The recovery time and recovery time of orientation in combination group were significantly shorter than propofol group and etomidate group,with statistical significance(P<0.05),but there was no statistical significance in above indexes between etomidate group and propofol group(P>0.05). The proportion of patients'memory ability,computing ability,orientation ability passing examination in combination group were significantly higher than propofol group,with statistical significance(P<0.05). There was no statistical significance in above indexes between combination group and etomidate group,between etomidate group and propofol group(P>0.05). There was no statistical significance in MMSE score of combination group at different time points (P>0.05);MMSE score of propofol group 15,30 min after anesthesia and that of etomidate group 15 min after anesthesia were significantly lower before anesthesia and combination group,with statistical significance(P<0.05). There was no statistical signifi-cance in MMSE score of propofol group 1 h after anesthesia,etomidate group 30 min and 1 h after anesthesia,compared to before anesthesia(P>0.05). The incidence of apnea,hypotension and injection pain in combination group and etomidate group were low-er than propofol group,the motor response,myoclonus,nausea and vomiting in combination group and propofol group were lower than etomidate group,the tachycardia ease in combination group was lower than propofol group,with statistical significance(P<0.05). CONCLUSIONS:Etomidate combined with propofol anesthesia shows good therapeutic efficacy for painless gastrointestinal endoscopy of elderly patient,can reduce cognitive dysfunction and shortens recovery time,but doesn't increase the occurrence of ADR.

Asthma ; diagnosis ; Exhalation ; Humans ; Nitric Oxide ; metabolism ; Respiratory Function Tests

ObjectiveTo explore the effects of personality characteristics and mental health of students on the career orientation.MethodsThe method of stratified random sampling was used in three universities of Jiangxi province.501 subjects of Arts,Science and Medical Science were tested with Holland career orientation test,symptom check list(SCL-90) and 16 personality factors(16PF).Structure validity analysis,analysis of variance and t -value test were employed with LISREL8.70 and SPSS13.0.Results ( 1 ) The proportion of students choosed the type of occupation were:social type 36％,management type 18％,conventional type 17％,reality type 14％,investigation type 9％,artistic type 6％ ; (2) Career orientation,personality characteristics and mental health had moderate effect on the career orientation.The correlation coefficients of personality characteristics and mental health to the vocational orientation were 0.63 and 0.44.The interaction correlation coefficient was 0.56.ConclusionPersonality characteristics and mental health of college students are important factors to the career orientation and decision-making of job seeking.The personality has stronger explanatory power than mental health.Great emphasis should be paid on both short-term psychological health of college students and long-term cultivation of healthy personality in the employment psychological guidance.