Objective To evaluate the short-term effect of open and laparoscopic cholecystectomy surgery on body.Methods Forty patients with cholecystectomy were divided into open surgery group and laparoscopic surgery group by random digits table method with 20 cases each.The clinical index was compared between two groups.The immunoglobulin G(IgG) and procalcitonin (PCT) before surgery and 4 d after surgery were determined.Results The operative blood loss,anal exhaust time,length of stay was (135.80 ±26.74) ml,(1.6 ±0.9) h,(6.7 ±3.2) d in open surgery group,which was better than that in laparoscopic surgery group [(63.41 ± 15.06) ml,(0.4 ± 0.3) h,(2.8 ± 1.9) d],and there was significant difference (P ＜ 0.05).The incidence of heat was 15％(3/20) in open surgery group,which was higher than that in laparoscopic surgery group (0),and there was significant difference (P ＜0.05).There was no significant difference in the IgG and PCT between two groups before surgery (P ＞ 0.05).The IgG and PCT at 4 d after surgery was (13.93 ± 1.98) g/L,(2 153.2 ± 1 452.1) mg/L in open surgery group,which was higher than that in laparoscopic surgery group[(9.23 ± 2.87) g/L,(768.0 ± 237.0) mg/L],and there was significant difference (P ＜ 0.05).Condmion Laparoscopic cholecystectomy has smaller short-term effects on body,while the body of the humoral and cellular immune function in mild,conducive to the body's recovery.

Objective To explore the adeB gene expression level impact of tigecycline for multidrug resistance Acinetobacter baumannii.Methods 57 strains multidrug resistance Acinetobacter baumannii were separated from September.2012 to September.2014.Epsilome test method was used to detect minimum inhibitory concentration of tigecycline against multi drug resistant Acinetobacter baumannii.PCR amplification detected adeB, adeR, adeS efflux pump gene distribution.Real-time fluorescent RT-PCR detection technology were used to detect relative expression level of each gene. Results 57 strains of multidrug-resistant Acinetobacter Bauman MIC value were 0.1-8μg/mL.The calculation of MIC50 =2μg/mL, MIC90 =4μg/mL. 49 strains sensitivity accounted for 86.0%, 5 intermediate strains accounted for 8.8%, 3 resistant strains accounted for 5.2%.57 strains of bacteria were divided into 38 strains lower sensitivity group and 19 strains sensitive group, with reduced susceptibility in lower sensitivity group 30 strains, accounting for 78.9%, sensitive group were all sensitive to tigecycline, accounting for 100%, for tigecycline susceptibility sensitive group was significantly higher than that of lower sensitivity group ( P <0.65 ) .41 strains were detected adeB, adeR, adeS gene in all strains, accounted for 86.0%, 29 strains were detected adeB, adeR, adeS genes in lower sensitivity group, accounted for 70.7%,12 strains were detected in sensitive group accounted for 63.2%, the difference between the two groups had no statistical significance.Fluorescent RT-PCR detection results showed that the relative expression of adeB gene with lower susceptibility group was significantly lower than that of sensitive group (P<0.05), relative expression levels of adeR and adeS gene in two groups had no significant difference.Conclusion AdeB gene plays an important role in tigecycline for multidrug resistance Acinetobacter baumannii, but may also exist outside of the adeB gene is involved in the regulation of resistance to tigecycline.

Objective:The efficacy and toxicity of anticancer drugs differ in different tumor patients. It could not meet the requirements of optimization of tumor treatment if only under the guidance of clinical and pathologic characteristics. More and more attention is focused on individualized therapy based on individual gene profiles. It has been identified that gene polymorphisms are responsible for different outcomes of individuals. Gene polymorphisms, including sequence polymorphism and single nucleotide polymorphism, will decrease the clinical efficacy of chemotherapeutic drugs or increase adverse reactions by influencing the expression or activity of the corresponding proteins. In recent years several gene polymorphisms related to drug metabolism, transportation, or inactivation may affect the outcomes of chemotherapy and the frequency of adverse reactions. Identification of the polymorphism genes is important for individual therapy for tumor patients.

Objective To investigate the effect of tripterysium glycosides combined with isotretinoin in cysticacne and its effect on serum inflammatory factors, insulin like growth factor 1 (IGF-1) and dehydroepiandrosterone (DHEA).Methods 118 cases of cysticacne patients were divided into observation group (n=59) and control group (n=59) according to the random number table method.Patients in the control group were treated with isotretinoin capsule, while the observation group were treated with tripterysium glycosides tablets on the basis of the control group.The course of treatment was 8 weeks in two groups.Results The total efficiency of the observation group (89.83%) was higher than the control group (71.19%) (P<0.05); the number of cyst after treatment in the observation group were less than the control group (P<0.05);the serum IL-2 and IL-4 levels in the observation group after treatment reduced, and lower than the control group (P<0.05);the serum IGF-1 and DHEA levels in the observation group after treatment reduced, and lower than the control group (P <0.05); the recurrence rate of the observation group (11.86%) was lower than the control group (30.51%) (P<0.05);the adverse reactions in two groups had no statistically significant.Conclusion Tripterysium glycosides combined with isotretinoin capsule has obvious curative effect in the treatment of cysticacne patients, and can reduce the serum IL-2, IL-4 levels and IGF-1 and DHEA levels, with lower recurrence rate, fewer adverse reactions.

Myoblast transplantation has been carried out for a certain period,but its efficiency in repairing inherited myopathy or severe muscular injury is not satisfactory.The improvements in myoblast culture,transplantation approach,recipient and cell preparation before transplantation,scaffold material and its selection,and body immunity can positively influence transplantation efficacy,and improve recipient function.In addition,these improvements influence the prospect of myoblast transplantation or cell-mediated gene therapy.

Objective　To better understand the clinical characters of juvenile onset spondyloarthropa-thies (JSpA).Methods　The clinical and laboratory data of 190 in-patients with JSpA were analyzed and the diagnosis,classification and differentiation of juvenile onset arthritis were discussed.Results　Among these 190 patients,163 were male,with a male to female ratio 6∶1.Of them 92.1% had the disease after the age of 8.Peak of age at onset was 12 to 15 years;157(82.6%) patients had peripheral arthritis and only 23(12.1%) patients felt low back pain at onset.During the disease course, peripheral arthritis was found in 187(98.4%) patients and the history of low back pain or buttock pain was recorded in 123(64.7%).The interval between peripheral arthritis and low back pain was from 0 to 20 years,with an average of (3.2±4.5)years.Extra-articular features including enthesitis in 67(35.3%)patients,dactylitis in 20(10.5%),iritis in 9(4.7%) were observed.HLA-B27 was positive in 87.9%(160/182) patients.Sacroiliitis on X-ray was observed in 76.0%(136/179) patients,and 106(55.8%) patients were diagnosed juvenile ankylosing spondylitis (JAS) according to 1984 New York modified criteria.The average disease course in JAS was (6.3±6.2) years,longer than that in JSpA (P＜0.01).Conclusion　The concept of JSpA is helpful to early diagnosis and treatment of juvenile onset arthritis.The JSpA are characterized by asymmetric lower limb predominant oligoarthritis,a wide spectrum of extra-articular features,presence of HLA-B27 and familial history of SpA or psoriasis.It will take an average of 6.3 years for JSpA patients to fulfill the diagnostic criteria of adult AS.

Objective:To analyze the clinical therapeutic effect and safety of large dosage of valsartan on chronic heart failure (CHF).Methods:A total of 106 CHF patients hospitalized in our department were chosen and ran-domly divided into routine dose group (n=53,received routine dosage of valsartan,80mg,once/d)and large dose group (n=53,received large dosage of valsartan,80mg,twice/d)accerding to number table.Both groups received anti-heart failure treatment for six months according to the guidelines.After treatment,plasma N terminal pro brain natriuretic peptide (NT-proBNP)level was measured,left ventricular end-systolic diameter (LVESd),left ventricu-lar end-diastolic diameter (LVEDd),interventricular septal thickness (IVST)and left ventricular posterior wall thickness (LVPWT)were measured by color Doppler echocardiography,and all patients received 6min walking test. Therapeutic effect and incidence rates of adverse reactions were compared and analyzed between two groups after treatment.Results: Compared with routine dose group,there were significant reductions in NT-proBNP level [(3042.6±116.3)pmol/L vs.(2565.8±98.2)pmol/L],LVESd [(34.5±2.2)mm vs.(29.4± 2.0)mm], LVEDd [(55.1±2.9)mm vs.(50.2±2.5)mm],IVST [(12.9±1.8)mm vs.(10.7±1.2)mm]and LVPWT [(11.8±1.1)mm vs.(10.9±0.9)mm];significant rise in 6min walking distance [(271.2±24.9)m vs.(367.7 ±22.3)m]and total effective rate (43.40% vs.62.26%)in large dose group,P <0.05 all.There was no signifi-cant difference in incidence rates of major adverse reactions between two groups (P >0.05).Conclusion:Large dos-age of valsartan is more effective and is safe in treatment of chronic heart failure.

Objective To explore the value of PCR for analyzing the pathogenic spectrum of bloodstream infection(BSI)in chil-dren with blood disease,and to provide a new thought for epidemiological survey of BSI.Methods A total of 80 children with blood disease in hematology department with suspected bacterial infections were recruited in the study,whose blood samples were collect-ed and detected by using blood cultivation(BC)and 16 S rDNA-PCR.The results obtained by the two methods were compared.Re-sults Among the 80 children,the positive rate of BC and PCR were 8.8% and 20.0%,respectively.There was significant differ-ence between the two methods(χ2 =5.82,P <0.05).Gram-positive bacteria and Gram-negative bacteria accounted for 68.7% and 31.3% respectively in 16 bacteria.The predominant pathogen was Staphylococcus epidermidis (31.3%).Conclusion Compared with BC,16 S rDNA-PCR and sequencing provide a new way for analyzing the pathogenic spectrum of BSI,which might be effective for epidemiological investigation.The pathogens of BSI are mainly Gram-positive bacteria in children of hematology department,and Staphylococcus epidermidis is the most common pathogen.

An initial forecast model of BP neural networks is established, and is trained using the history data of our hospital inventory. This model is applied to forecasting the demand of medical equipment in Daping Hospital. The result indicates that the inventory cost is reduced enormously. The model is useful in the purchase and inventory management of medical equipment.

In accordance with the feature of apoplectic dysarthria, it is divided into three types of labial pattern, lingual pattern and laryngeal pattern.The therapeutic methods are respectively explained with case examples.