Objective To investigate the application effect of flexible management in nursing of general surgery department. Methods 21 nursing staff and 836 patients from January to October, 2007 were selected as research object, and were given flexible management. 21 nursing staff and 797 patients from January to December were selected as the control. The influence of flexible management on nurses and patients and satisfaction degree with nursing work before and after application of flexible management were compared. Results Working and learning enthusiasm greatly improved,educational background and professional titles of nurses increased after application of flexible management. The average hospitalization time was 28 days,the per capita cost was 12 131 yuan,satisfaction degree with nursing was 87.0% before application of flexible management, but the average hospital stay of patients decreased to 20 days, the per capita cost decreased to 8764 yuan and satisfaction degree with nursing increased to 97.0% after application of flexible management. Conclusions Application of flexible management in nursing care of general surgery department showed significant effect,it is suitable for more application in practice.

[Objective]To explore the correlation of the expression of alpha-fetoprotein(AFP)mRNA in the peripheral blood and postoperative survival and metastasis of patients with liver cancer.[Methods] A total of 66 patients with liver cancer who received radical resection surgery from January 2005to December 2006 was enrolled in this study.The cell total RNA was extracted from peripheral blood and the expression of AFP mRNA was detected by nested PCR.All the patients were followed up for 60 months after surgery.[Results]The expression rate of AFP mRNA in the peripheral blood was 40.91％(27/66).The expression of AFP mRNA in the peripheral blood in patients with liver cancer was significantly related to microvascular invasion and metastasis(P ＜ 0.05 or ＜ 0.01),but the expression had no relationship with sex,age,HBV infection,cirrhosis,AFP concentration,tumour size and number,and Edmondson grading(P＞0.05).The overall 1,2,and ＞ 3 years survival rates of patients with positive AFP mRNA after surgery were 66.7％(18/27),38.9％(7/18),28.6％(2/7),respectively.The overall 1,2,and ≥3 years survival rates of patients with negative AFP mRNA after surgery were 84.6％(33/39),60.6％(20/33),45.0％(9/20).There was statistical significance between the survival rates of AFP mRNA-negative patients and AFP mRNApositive patients(P ＜ 0.01).[Conclusions] The detection of AFP mRNA in the peripheral blood may provide clue for early microscopic metastasis.It can be a prediction index for postoperative recurrence.

Objective To investigate the expression of LRP16 gene in lung cancer, and explore its clinicopathological significance. Methods Fresh resected tissues from 54 patients with primary lung cancer were collected and the clinicopathological data were gathered. The expression of LRP16 protein in cancer tissues and the matched normal tissues were determined by Western blotting, and the relationship between LRP16 expression and clinicopathological data was analyzed. It was defined as overexpression when the LRP16 expression of cancer tissues was twice or more higher than that of matched normal tissues. Results The LRP16 was overexpressed in 15 out of 54 patients with lung cancer (27.8%). Among the 23 patients with adencarcinoma, the overexpression of LRP16 was found in 11 cases (47.8%), while in the patients with squamous carcinoma, the overexpression of LRP16 was only found in 4 out of 27 cases (14.8%), and there was a significant difference between the two groups (Pearson test, P=0.0258). Besides, very low expression or non-expression of LRP16 was found in 2 large cell lung cancer and 2 small cell lung cancer. The overexpression rate of LRP16 was 20.0% (2/10) in tumor with diameter less than 3cm and 29.5% (13/44) in tumor with diameter ≥3cm, and there was no significant difference between the two groups (Pearson test, P=0.7224). Conclusions There were significant differences of LRP16 overexpression in cases of adencarcinoma or squamous carcinoma with or without lymphatic metastasis. It is suggested that LRP16 is a tumor-related gene of lung cancer, and may play an important role in molecular staging of lung cancer.

Objective To summarize the characteristics on diagnosis and therapy of adult diaphragmatic eventration. Method The clinical data of 26 patients with adult diaphragmatic eventration, hospitalized in General Hospital of PLA from 1988 to 2009, were retrospectively analyzed. The 26 patients, 14 males and 12 females, were aged from 26 to 66 (mean 44.0?5.7), with disease course of 8 months to 17 years. Among them 25 suffered from left and 1 from right diaphragmatic eventration; 24 with total and 2 with localized diaphragmatic eventration; of them 2 without symptoms were detected in physical examination, and among the 24 remainders 18 were with the symptoms of thoracic discomfort after eating, 8 with dyspnea after activities, 14 with hiccup, vomiting and abdominal discomfort. Most of the patients had more than one symptom. All patients received operations via the chest cavity under general anesthesia, 24 cases were performed by double mattress suture with diaphragm discission, while 2 cases by fold suture without diaphragm discission. Results Symptoms relief was reported in 24 patients at the early stage after operation. Eighteen patients were followed up for one year, and 15 of them received chest radiograph, among whom the normal diaphragm localization were in 13 cases and relatively higher diaphragm localization in 2 cases, while the other 3 patients received no re-examination of chest radiograph. Among the 18 cases receiving one year of follow-up, 10 cases got complete disappearance of symptoms, 6 cases got symptoms relieved or partially disappeared, and 2 patients got symptom relapsed. Conclusion Surgical outcome, especially the double mattress suture is satisfactory for adult diaphragmatic eventration.

The importance of classics on traditional Chinese medicine in training talents of traditional Chinese medicine was analyzed according to the fact that education of classics on traditional Chinese medicine is increasingly marginalized.After the serial activities of reading classics, learning classics, and using classicsin libraries of colleges and universities of traditional Chinese medicine were described , the advantages and disadvantages of such activities were summarized with certain suggestions put forward for overcoming the disadvantages .

Objective To compare the clinical efficacy of two surgical methods for the treatment of anal fissures in elderly patients.Methods A total of 138 elderly patients with anal fissures treated at our hospital from January to December 2016 were randomly divided into the conventional method group(69 cases) and the modified method group (69 cases).Patients in the conventional method group were treated with lateral sphincterotomy,while patients in the modified method group were treated with modified longitudinal sphincterotomy with transverse suture.Outcomes of treatment,VAS scores,incision wound infection rates,postoperative voiding dysfunction rates and recurrence rates were compared.Results There was no significant difference in overall effectiveness between the modified method group (98.6％)and the conventional method group(94.2％) (x2=1.8677,P=0.1717).The rates of incision wound infection,moderate postoperative urinary retention and recurrence in the conventional method group(8.7％,42.0％ and 10.1 ％,respectively)were significantly higher than those in the modified methods group(0.0 ％,15.9 ％ and 0.0％,respectively) (x2 =4.3561,11.4061 and 5.4177,respectively,P =0.0369,0.0007 and 0.0199,respectively).At 12 hours after operation,favorable VAS scores and incision healing times were observed in the modified method group,compared with the conventional method group,and the differences were statistically significant(each P＜0.05).Conclusions Modified longitudinal sphincterotomy with transverse suture produces about the same overall effectiveness as does lateral sphincterotomy in the treatment of elderly patients with anal fissures,but it is superior in reducing incision wound infection,moderate postoperative voiding dysfunction,recurrence and pain intensity,and in promoting incision healing.

, which will provide enough seed cells for peripheral nerve tissus engineering research.

Objective To explore effect of diosmin on serum and prostatic fluid immune mediated factors and clinical effect in patients with chronic prostatitis.Methods 89 cases of old male patients with chronic non bacterial prostatitis were selected, and divided into two groups.The control group were treated with universal tablets, the experiment group were treated on the base of the control group with diosmin.12 weeks as a course.Clinic effect, adverse reaction rate, prostatic fluid MIP-2 and MIP-1αwere compared after treatment.Results Compared with control group, MIP-1αand MIP-2 in serum and prostatic fluid were lower(P<0.05),NIH-CPSI score and QOL scores were lower(P<0.05), total effective rate was higher than control group(P<0.05),the incidence of adverse reactions was lower(P<0.05).Conclusion Diosmin can reduce MIP-1α, MIP-2 in serum and prostate fluid of patients with chronic none bacterial prostatitis, and improve the pelvic pain, dysuria, sexual dysfunction and other symptoms, and has less adverse reaction.

Objective To expore the difference between magnetic resonance image ( MRI) expression of spinal tuberculosis and brku-cellare spondylitis. Methods Retrospectively analyzed the clinical data of 10 patients with tuberculous spondylitis and 12 patients with bru-cellar spondylitis from Jan. 2012 to Oct. 2013. All the patients were scanned by MRI, and the expression difference of MRI were compared. Results The vertebral body of spinal tuberculosis was destroyed severely, and it often accompanied by the kyphosis and multiple-level para-vertebral abscess, and even adjacent organs tuberculosis. The vertebral body of brucellar spondylitis was destroyed lightly,and the abscess is often limited. Conclusion We can distinguish spinal tuberculosis and brucellar spondylitis by the typical difference of the expression of MRI.

Objective To investigate the effects of CSK-conjugated PLGA nanoparticles on oral delivery of insulin in vitro and in vivo.Method CSK-INS-NPs were prepared by double-emulsion. Nanoparticle size、zeta potential and entrapment efficiency were measured. The efficiency of cellular uptake on Caco-2 cells in vitro was evaluated. The hypoglycemic effects were evaluated by monitoring the glucose levels in diabetic rats. Results The average sizes was(134. 4 ± 15)nm and their PDI values were less than 0.3.The insulin entrapment efifciency was around 71%. The cellular uptake of CSK-INS-NPs by Caco-2 cells was 2.8 times higher than INS-NPs. The CSK-INS-NPs transferred more insulin across the Caco-2 cell monolayer than INS-NPs and insulin solution did. In vivo experiments,the CSK-INS-NPs could reduce the blood glucose level of diabetic rats after oral administration in 10 h.Conclusion Compared with insulin solution,CSK-INS-NPs enhanced the insulin through Caco-2 cell monolayer by transcellular pathway and may be a potential delivery system for Oral Delivery of Insulin.