With the progress of minimally invasive surgical techniques,the vast majority of general surgery can be safely carried out laparoscopically.But the development of the pancreas laparoscopic surgery is lagging behind.Initially laparoscopy was used only as a diagnostic and staging tool.Nevertheless with more and more successful launch of laparoscopic surgery.Surgeons devoted a great deal of energy to this field in order to benefit more patients.This review focused on the literature of laparoscopic pancreatic surgery in resent years,although the majority of literature suggests that the minimally invasive pancreatic surgery has advantages of rapid recovery,low complication rate compared to traditional open surgery.However,most studies are limited to a small sample and a single institution results.The promotion of this emerging technology still needs more rigorous evidence based medicine.

According to TCM theory of the wholistic concept and the principles of syndrome differentiation and treatment, the characteristics of the pathogenesis of aplastic anemia (AA) were summarized and corresponding treatment was put forward on the basis of clinical observation and the study of literature. In the pathogenesis of AA, the deficiency of spleen and kidney is the primary aspect, fire attacking blood vessels is the secondary aspect and there is change because of blood stasis. In treatment, the method of invigorating spleen and tonifying kidney is adopted in order to get at the root, and releasing fire to stop bleeding is adopted in order to bring about a temporary solution, and activating blood circulation to dissipate blood stasis is adopted in order to produce blood. The outline should be caught hold of that consumption is primary aspect and fire is secondary aspect and there is change because of blood stasis in order to obtain satisfactory curative effect.

Objective: To observe the clinical therapeutic effect of Pyretic Arthralgia granules in treating rheumatoid arthritis of moist heat arthralgia spasm syndrome,so as to provide scientific evidence in clinical Medication.Methods: Adopted random and positive parallel contrast methods,60 cases of active stage rheumatoid arthritis(RA) patients whom were differentiated of symptoms and signs as moist heat arthralgia spasm syndrome were divided into groups.Experimental group took Pyretic Arthralgia granules 2.0 g every time and 3 times a day orally;control group took Loxonin orally,60 mg every time and 3 times a day.Both course of treatment in two sets were 4 weeks.Results: Experimental group and control group all could improve present symptoms,physical signs and physical-chemical index.There was not significance variance in two groups comparing the disease therapeutic effect with the therapeutic effect of syndrome of traditional Chinese medicine.Conclusion: Pyretic Arthralgia granules has the effects of detumescence,alleviating pain and improving Joint function,and has not obvious poison and side reaction.It is good for further generalizing and applying.

Objective Health education provided by medical staffs can promote the patients 'abilities of self management . This article explored the teaching mode of health education course for nursing students of college to undergraduate level . Methods Reform took place in the course of health education for nursing students of Grade 2009 to 2012 who studied in the medical school of col-lege to undergraduate in Nanjing Genernal Hospital .The unidirectional teaching method was replaced by trinity teaching method which included cases , situational analogue training and clinical situation experience .In their clinical internship , the same questionnaire was used by designated personnel to survey the satisfaction degree of the patients , the clinical teachers and the nurses themselves .Analysis and comparison were conducted on the materials of satisfaction degree from 2009 to 2011 . Results Significant difference was found in the satisfaction degree of the patients , the clinical teachers and the nurses before and after the application of trinity teaching model (93.4%vs 56.9%, 91.6%vs 59.7%, 99.3% vs 78.1%). Conclusion The trinity teaching model is of high practical value , which is worth popularizing .

Objective To explore the most suitable condition of influenza virus which was culturing on plateau region,and im-prove the effect of the separation of influenza virus.Methods The original specimens were respective inoculated in MDCK cells,by comparing CO2 percent concentration (5%,4.8%,4.6%,4.4%,4.2%),TPCK-pancreatic enzyme dosage (1,2,3, 4,5μg/m and 6,8,10μg/ml),inoculation amount (100,200,300,400,500μl),incubation time (48,72,96,120,144 h),inoc-ulation methods (adsorption,direct inoculated),and culture vessel(cells,6 orifice)that were influenced on influenza virus, the best culture conditions was determined.Hemagglutinatio (HA)method was used to detect the virus titers.Results Through the comparison,the HA titer of virus was in the highest titer with 6 orifice plate culture vessel,4.4% CO2 and 4.6% CO2 ,2μg/ml TPCK-pancreatic enzyme,300μl and 400μl inoculation amount,72h~96h of incubation time.Conclusion The optimal condition of the influenza virus cultured with the MDCK cell has been established in the laboratory on plateau region.

Objective To study comprehensive methods for senile hypertension and compared with conven-tional western medicine treatment,and provide reference to guide clinical hypertension treatment for the future. Methods 162 cases with senile hypertension were selected in our hospital,according to the order of treatment and the principle of informed consent,they were randomly divided into observation group and control group.The control group was given conventional western medicine treatment,the Nifedipine sustained release tablets joint irbesartan tab-lets.Based on the thinkings of health management,we established health records for observation group firstly,then as-sessed cardiovascular risk among patients.The patients with low,moderate risk were conducted the continuous monito-ring of blood pressure,health education,the key intervention in their way of life,established a good mentality.If the blood pressure was still unstable and out of control,we began to consider the use of drug.For patients with high risk or very high risk,besides the treatment considered,they needed immediate medical treatment supplemented by traditional Chinese medicine.Observation group was followed up for 1 time,and lasting for 6 months,then their blood pressure was measured again,the treatment effect and adverse reactions were evaluated.Results The total effective rate of ob-servation group was 96.7% (89 /92),which was significantly higher than that of control group 82.8% (58 /70),χ2 =9.12,P <0.01,the difference was statistically significant.After following up for 6 months,the systolic blood pressure of observation group fell to (126.1 ±21.5 )mmHg,t =7.548,P <0.01;diastolic blood pressure fell to (79.5 ±9.5)mmHg,t =10.703,P <0.01,the change was significantly different than before.The systolic blood pres-sure of control group fell to (145.3 ±26.7)mmHg,t =1.979,P <0.05,there was markedly reduced,diastolic blood pressure decreased too,but there was no statistical difference (P >0.05).So the effect of observation group was better than control group.Meanwhile,some adverse reaction occurred in both groups,but there was no significant difference. Conclusion With the thinking of health management for aged patients with hypertension,offer full -course treatment for them in order to increase the awareness of hypertension and establish healthy lifestyle,guide scientific and rational drug use.The integrated use of these methods can effectively improve the effect of the treatment of senile hyperten-sion,which is worthy of popularization and application.

Pseudomonas aeroginosa exotoxin A(PEA) was purified from the strain PA103 and labelled with Ⅰ~(125).Then autoradiographic tracing,histopathological observations with light and electron microscopes,and antiserum protestion test were carried out on inbred mice BALB/C.The results indicate that the liver is the target organ of PEA,and both the hepatocytes and kupffer cells the target cells,on which the severe damage may be responsible for the acute death of the toxicated animals.

After a single oral dosed mg/kg) of nitroquine to the mice infected with Plasmodium yoelii,the morphological changes of the parasites were studied with optical and electron microscopy.Enlarged nucleus and some red granules scattered over the cytoplasm in the late trophozoites were observed under optical microscope,which may correspond to the autophagocytic vacuo-les or membranous residual bodies seen under electron microscope.Thirty minutes after the drug administration,the number of mitochondria with matrix cavitation was increased,the endoplasmic reticulum dilated,and ribosomes separated,detached,or disaggregated.Then the pelliculous complex and nuclear membrane of the parasites proliferated to form multi-layered structure with spiral curv?s or myelin sheath-like structure in the cytoplasm.The nuclear membrane was swollen and proliferated and the perinuclear cisterna was widened.In the late stage of drug action,the structure of the parasites was broken down to form a large number of autophagocytes.The findings indicate that nitroquine interferes with the structure and function of the cell membrane,cytoplasm and nucleus of malaria parasites and exerts its anti-malarial effects from many aspects.

Mammals have three genes with homology to the hh gene.These comprise Sonic hedgehog(Shh),Indian hedgehog(Ihh),and Desert hedgehog(Dhh).Shh has been shown to play a crucial role in embryogenesis and the development of ectoderm.Shh has the great relationship with the forming all the system.Shh-Patched-Smoothened signal pathway will lead the embryogenesis in the normal way.Otherwise,the abnormal embryogenesis,malformation,and tumor will be happened.